The impact of salvage radiotherapy (SRT) on cancer-specific outcomes stratified according to the European Association of Urology biochemical recurrence (BCR) risk classification was assessed.
Conversely, surveillance might be suitable for low-risk BCR, since only nine patients with low-risk BCR died from prostate cancer during follow-up. Our results suggest recommending early SRT for high-risk BCR men. Improved survival was recorded within the high-risk BCR group for patients treated with early SRT compared with those under observation. Late SRT was a predictor of cancer-specific death (HR: 0.17, p < 0.01) but not death (p = 0.1). In multivariable analyses, early SRT decreased the risk for death (hazard ratio : 0.55, p < 0.01) and cancer-specific death (HR: 0.08, p < 0.001).
For high-risk BCR, 12-yr overall survival was 81% versus 66% (p < 0.001) and cancer-specific survival was 98% versus 82% (p < 0.001) for early versus no SRT. For low-risk BCR, 12-yr overall survival was 87% versus 78% (p = 0.2) and cancer-specific survival was 100% versus 96% (p = 0.2) for early versus no SRT. The median follow-up was 54 mo after BCR for survivors. Overall, 8 patients were classified as having EAU low- and high-risk BCR. The Simon-Makuch method tested for survival differences within each risk group.
Multivariable Cox models tested the effect of SRT versus no SRT on death and cancer-specific death. Outcome measurements and statistical analysis: Early and late SRT were defined as SRT delivered at prostate-specific antigen values <0.5 and ≥0.5 ng/ml, respectively. To assess whether this risk stratification helps in choosing patients for salvage radiotherapy (SRT).Īnalyses of 2379 patients who developed BCR after RP (1989-2020), within ten European high-volume centers, were conducted. Electronic address: European Association of Urology (EAU) has proposed a risk stratification for patients harboring biochemical recurrence (BCR) after radical prostatectomy (RP). 17 Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany Department of Urology, Koc University Hospital, Istanbul, Turkey.Electronic address: 1 Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany Department of Urology, University Hospital Frankfurt, Frankfurt, Germany. 16 Department of Urology, Antonius Hospital, Utrecht, The Netherlands.15 Department of Radiotherapy and Radiooncology, University Hospital Ulm, Ulm, Germany.14 Department of Urology, Urological Research Institute, Vita-Salute University and San Raffaele Hospital, Milan, Italy.13 Department of Urology, University Hospital Frankfurt, Frankfurt, Germany.12 Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland Department of Urology, University Zurich, Zurich, Switzerland.11 Department of Therapeutic Radiology and Oncology, Medical University Innsbruck, Innsbruck, Austria.10 Department of Urology, Medical University Innsbruck, Innsbruck, Austria.9 Department of Urology, La Paz University Hospital, Madrid, Spain.8 Radiation Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.7 Department of Urology, Clinico San Carlos Hospital, Madrid, Spain.6 Department of Radiation Oncology, University Hospital of Udine, ASUIUD, Udine, Italy Department of Radiation Oncology, Hospital San Martino, Belluno, Italy.5 Department of Surgery, Oncology and Gastroenterology, Urology Clinic, University of Padova, Padova, Italy.4 Department of Radiation Oncology, Charité University Hospital, Berlin, Germany.3 Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.2 Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.1 Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany Department of Urology, University Hospital Frankfurt, Frankfurt, Germany.
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