Patterns of care and outcomes of radiotherapy for lymph node positivity after radical prostatectomy
Article first published online: 2 APR 2013
© 2013 BJU International
Volume 111, Issue 8, pages 1208–1214, June 2013
How to Cite
Kaplan, J. R., Kowalczyk, K. J., Borza, T., Gu, X., Lipsitz, S. R., Nguyen, P. L., Friedlander, D. F., Trinh, Q.-D. and Hu, J. C. (2013), Patterns of care and outcomes of radiotherapy for lymph node positivity after radical prostatectomy. BJU International, 111: 1208–1214. doi: 10.1111/bju.12079
- Issue published online: 28 MAY 2013
- Article first published online: 2 APR 2013
- Department of Defense Prostate Cancer Physician Training Award. Grant Number: W81XWH-08-1-0283
- prostate cancer;
- radical prostatectomy;
- radiation therapy;
- To evaluate the use and outcomes of adjuvant radiation therapy (ART) for men with lymph node (LN)-positive disease after radical prostatectomy (RP) using a population-based approach.
Patients and Methods
- Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data from 1995 to 2007 was used to identify 577 men with LN metastases discovered during RP and absence of distant metastases, of which 177 underwent ART ≤1 year of RP.
- Propensity score models were used to compare overall mortality and prostate cancer-specific mortality (PCSM) for men that did and those that did not receive ART.
- Men in both groups received adjuvant androgen-deprivation therapy at similar rates after propensity weighting adjustments (33.6% vs 33.7%, P = 0.977).
- ART was not associated with differences in overall (5.09 vs 3.77 events per 100 person-years, P = 0.153) or PCSM (2.89 vs 1.31, P = 0.090) relative to men who did not receive ART.
- ART after RP in men with LN-positive prostate cancer was not associated with improved overall or disease-specific survival, in contrast to previous single-centre studies.
- Prospective randomised studies are needed to assess the effectiveness of ART in this patient population.