A non-negligible proportion of prostate cancer (PCa) patients undergoing radical prostatectomy (RP) harbors aggressive disease. These individuals are at higher risk of experiencing recurrence after surgery.
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Results from prospective, randomized trials support the efficacy of adjuvant radiotherapy (aRT) on cancer control in selected patients with adverse disease features at RP. However, only one of these randomized trials found a significant benefit of aRT on survival. Although such a level of evidence is not currently available for salvage RT, retrospective studies demonstrated that this approach leads to excellent outcomes if administered at the earliest sign of PSA recurrence. Prognostic models might help clinicians in identifying patients who would benefit the most from adjuvant and/or salvage RT. This individualized approach would allow sparing the risk of short- and long-term toxicity in a substantial proportion of patients. Nonetheless, results from randomized trials are still awaited to compare the efficacy of (early) salvage and aRT.
Current oncology reports. 2015 Dec [Epub]
Giorgio Gandaglia, Cesare Cozzarini, Alexandre Mottrie, Alberto Bossi, Nicola Fossati, Francesco Montorsi, Alberto Briganti
Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy. Department of Radiotherapy, IRCCS Ospedale San Raffaele, Milan, Italy. , OLV Vattikuti Robotic Surgery Institute, Melle, Belgium. , Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France. , Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy. , Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy. , Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.