Hackman G 1 1 Faculty of Medicine, University of Helsinki, Helsinki, Finland , Taari K 2 2 Department of Urology, Helsinki University Hospital, Helsinki, Finland , Tammela TL 3 3 Department of Surgery, Tampere University Hospital, Faculty of Medicine and Life Sciences, Tampere University, Tampere, Finland , Matikainen M 2 2 Department of Urology, Helsinki University Hospital, Helsinki, Finland , Kouri M 4 4 Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland , Joensuu T 5 5 Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland; Docrates Cancer Center, Helsinki, Finland , et al.
COMMENT
The latest guideline suggest adjuvant radiotherapy or observation following prostatectomy with adverse pathological findings (11. Mohler JL, Antonarakis ES, Armstrong AJ, D’Amico AV, Davis BJ, Dorff T, et al. Prostate Cancer, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2019;17:479-505., 22. Mottet N, Cornford P, van den Bergh RCN, Briers E, De Santis M, Fanti S, et al. EAU - ESTRO - ESUR - SIOG Guidelines on Prostate Cancer, available at. <https://uroweb.org/guideline/prostate-cancer> accessed July 11, 2019.
https://uroweb.org/guideline/prostate-ca...
). This trial randomized 250 patients (1:1) with pT2N0M0 with positive margins or pT3aN0M0 and tries to answer if there is a benefit from adjuvant radiotherapy after radical prostatectomy. The postoperative PSA was less than 0.5. The median follow-up for alive patients was 9.3 yr and 8.6 yr in the adjuvant and in the observation group respectively. The primary endpoint was biochemical recurrence-free survival (BCRFs) and the overall survival, cancer-specific survival, and adverse events were the secondary ones.
The authors founded a 74% benefit of BCRFs in the adjuvant group, and the number needed to treat was 4. There were no difference in the overall survival and in cancer-specific survival, with more grade 1 and 2 adverse events in the adjuvant group.
The first results of the RADICALS trial (NCT 005541047) recently presented at ESMO Congress 2019 did not show any benefit in BCRFs (secondary endpoint), supporting the use of early salvage radiotherapy.
REFERENCES
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1Mohler JL, Antonarakis ES, Armstrong AJ, D’Amico AV, Davis BJ, Dorff T, et al. Prostate Cancer, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2019;17:479-505.
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2Mottet N, Cornford P, van den Bergh RCN, Briers E, De Santis M, Fanti S, et al. EAU - ESTRO - ESUR - SIOG Guidelines on Prostate Cancer, available at. <https://uroweb.org/guideline/prostate-cancer> accessed July 11, 2019.
» https://uroweb.org/guideline/prostate-cancer
Publication Dates
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Publication in this collection
31 July 2020 -
Date of issue
Sep-Oct 2020
