Retrospective Cohort Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Urol. Mar 24, 2016; 5(1): 45-52
Published online Mar 24, 2016. doi: 10.5410/wjcu.v5.i1.45
Adjuvant radiotherapy for pathologically advanced prostate cancer improves biochemical recurrence free survival compared to salvage radiotherapy
Robert H Blackwell, William Gange, Alexander M Kandabarow, Matthew M Harkenrider, Gopal N Gupta, Marcus L Quek, Robert C Flanigan
Robert H Blackwell, Gopal N Gupta, Marcus L Quek, Robert C Flanigan, Department of Urology, Loyola University Medical Center, Maywood, IL 60153, United States
William Gange, Alexander M Kandabarow, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, United States
Matthew M Harkenrider, Department of Radiation Oncology, Loyola University Medical Center, Maywood, IL 60153, United States
Author contributions: All the authors contributed to this paper.
Institutional review board statement: The study was approved by the institutional review board.
Informed consent statement: Given the retrospective nature of this study with minimal risk of harm, patient informed consent was waived by the institutional review board.
Conflict-of-interest statement: All of the authors report no conflict of interest (financial or otherwise) related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Robert H Blackwell, MD, Department of Urology, Loyola University Medical Center, 2160 S, First Avenue, Building 54, Room 261, Maywood, IL 60153, United States. rblackwell@lumc.edu
Telephone: +1-708-2165100 Fax: +1-708-2161699
Received: September 2, 2015
Peer-review started: September 8, 2015
First decision: October 16, 2015
Revised: November 24, 2015
Accepted: January 8, 2016
Article in press: January 11, 2016
Published online: March 24, 2016
Processing time: 198 Days and 14 Hours
Core Tip

Core tip: We evaluated the outcomes of patients who received post-prostatectomy radiotherapy (RT) who had adverse features on the pathologic specimen and an immediately undetectable prostate specific antigen (PSA) postoperatively. In this cohort of patients, those who received RT in the adjuvant therapy (e.g., while PSA remains undetectable) had an improved 5-year biochemical recurrence (BCR)-free survival of 78%, compared to 50% for patients receiving RT in the salvage setting (e.g., after the postoperative PSA has again become detectable). As such, adjuvant RT improves BCR free survival in post-prostatectomy patients with adverse pathologic features and an undetectable PSA compared to salvage RT.