The impact of adjuvant therapy in patients with biochemical recurrence on prostate cancer progression and mortality five years after radical prostatectomy

Introduction. The clinical significance of biochemical recurrence (BCR) after radical prostatectomy (RP) due to prostate cancer (PCa) is not unambiguous, sometimes being independent from the real progression. BCR is followed by a greater risk of adverse events and almost always results with the necessity for implementation of adjuvant therapy (AT). The aim of the following study was to examine the impact of AT in patients with BCR together with PCa progression and mortality 5-years after RP. Material and methods. Two hundred forty-seven patients after RP, who were treated in the period from 1995 to 2009, underwent the retrospective analysis. They were divided into three groups according to the applied AT after prior BCR diagnosis. The first group (n - 39) included patients treated with radiotherapy, along with hormonotherapy. The second group (n - 63) covers patients receiving hormonotherapy only. The third group (n - 145) consists of patients without BCR. Five-year general and disease-specific survival was evaluated and choice prognostic factors were compared. Results. Five-year overall survival was 74.2% in group I, 88.3% in group II, and 98.7% in group III. Disease-specific survival was: 76.9%, 90.5%, and 100% (p = 0.001), respectively. BCR was diagnosed in 102 (41.5%) patients; while in another 24 (23.5%) of them progression was diagnosed after the AT was applied. Conclusions. The risk of BCR 5-years after RP is greater in patients with high initial concentration of PSA, higher Gleason score, and clinical advancement. Five-year overall and disease-specific survivals are higher among patients after hormonotherapy alone compared to those after both radio-and hormonotherapy.