Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
2000-10-12
pubmed:abstractText
Radical prostatectomy can be an effective therapy for men with organ-confined disease. However, extension beyond the confines of the prostate (pT3) can be found in many men, and this is often associated with longterm prostate-specific antigen (PSA) failure. Not all patients will progress with pT3 disease. The identification of additional adverse prognostic features (high Gleason score, PSA greater than 10 ng/mL, and seminal vesical invasion) can help identify those men at highest risk of progression following definitive surgery. The role of postoperative therapy in patients with high-risk features is often controversial. The lack of long-term survival benefit, toxicity, and cost are often cited. We reviewed our experience with a unified approach to this patient population and performed matched-pair analysis of patients with similar adverse prognostic features treated with and without postoperative radiation therapy. For our series, the results indicate that the addition of adjuvant radiation therapy is associated with a significantly reduced risk of PSA recurrence. The 5-year bNED rate after adjuvant radiation therapy was 89% (95% CI: 76% to 100%) compared with 55% (95% CI: 34% to 79%) after surgery alone (P = .002). This benefit also appears to hold true for men with pathological involvement of their seminal vesicles. A dose-response curve was observed with improved disease control above a level of 61.2 Gy. Appropriate patient selection and delivery of an adequate dose of radiation can improve the PSA recurrence of most patients with pT3 disease.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
May
pubmed:issn
1081-0943
pubmed:author
pubmed:issnType
Print
pubmed:volume
18
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
115-20
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:10875451-Adenocarcinoma, pubmed-meshheading:10875451-Adult, pubmed-meshheading:10875451-Aged, pubmed-meshheading:10875451-Case-Control Studies, pubmed-meshheading:10875451-Disease-Free Survival, pubmed-meshheading:10875451-Dose-Response Relationship, Radiation, pubmed-meshheading:10875451-Follow-Up Studies, pubmed-meshheading:10875451-Humans, pubmed-meshheading:10875451-Male, pubmed-meshheading:10875451-Matched-Pair Analysis, pubmed-meshheading:10875451-Middle Aged, pubmed-meshheading:10875451-Neoplasm Invasiveness, pubmed-meshheading:10875451-Postoperative Care, pubmed-meshheading:10875451-Prognosis, pubmed-meshheading:10875451-Prostate-Specific Antigen, pubmed-meshheading:10875451-Prostatic Neoplasms, pubmed-meshheading:10875451-Radiotherapy, Adjuvant, pubmed-meshheading:10875451-Radiotherapy Dosage, pubmed-meshheading:10875451-Salvage Therapy, pubmed-meshheading:10875451-Seminal Vesicles
pubmed:year
2000
pubmed:articleTitle
Durable efficacy of adjuvant radiation therapy for prostate cancer: will the benefit last?
pubmed:affiliation
Department of Radiation Oncology, Jefferson Medical College and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA.
pubmed:publicationType
Journal Article