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. 2016 Apr;39(2):167-72.
doi: 10.1097/COC.0000000000000032.

Long-term Outcomes Following Radiation Therapy For Prostate Cancer Patients With Lymph Node Metastases at Diagnosis Treated With and Without Surgery

Gilles Crehange  1 , Alejandra Izaguirre, Vivian Weinberg, Charles C Hsu, Alexander R Gottschalk, I-Chow Hsu, Katsuto Shinohara, Peter Carroll, Mack Roach 3rd
Affiliations

Long-term Outcomes Following Radiation Therapy For Prostate Cancer Patients With Lymph Node Metastases at Diagnosis Treated With and Without Surgery

Gilles Crehange et al. Am J Clin Oncol. 2016 Apr.

Abstract

Objectives: To evaluate the long-term outcomes for prostate cancer (PCa) patients with lymph node involvement (LNI) treated with radiotherapy at the University of California San Francisco.

Materials and methods: All newly diagnosed PCa patients with LNI treated with radiotherapy as primary therapy or after surgery, each with and without hormonal therapy (HT) between 1988 and 2009 were included.Thirty-five patients (38%) were managed with external beam radiotherapy alone (eRT), 18 patients (20%) with radical prostatectomy (RP)+adjuvant radiotherapy, and 38 patients (42%) with RP+salvage radiotherapy. Overall 82% of the study sample received HT with similar proportions among radiation therapy (RT) subsets (P=0.83).

Results: The median follow-up (FU) was 65, 42, and 86 months for patients treated with eRT, adjuvant radiotherapy, and salvage radiotherapy, respectively.The 10-year estimates from start of primary therapy for patients with LNI for overall survival (OS) was 78% (95% confidence interval [CI], 62%-88%) and for cause-specific survival was 89% (95% CI, 78%-95%). The 5-year estimates from the start of RT for biochemically no evidence of disease was 68% (95% CI, 56%-78%) and for disease-free survival was 67% (95% CI, 54%-77%). There was no difference in any of these outcomes among the 3 RT groups.Patients treated with HT were more likely to have a better 10-year OS (82% vs. 66%; log rank: P=0.001).Multivariate analysis indicated that only age and Gleason score were significant predictors for biochemically no evidence of disease and OS.

Conclusions: Patients diagnosed with PCa with LNI who were treated with RT with or without a prior surgery had relatively favorable long-term outcomes.

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