Influential Factors in the Response to Salvage Radiotherapy After Radical Prostatectomy

Objective: To analyze the influential factors in the response in prostatectomized patients with subsequent biochemical relapse (BCR) and treated with salvage radiotherapy (RTP). Material and methods: We analyzed 313 patients with pT2/pT3 prostate cancer who were receiving salvage therapy due to biochemical relapse (from a series of 1,310 radical prostatectomies between 1989-2012). Of the 313 patients; 159 (50.8%) only received androgen deprivation (AD), 63 (20.1%) Radiotherapy (RTP) plus concomitant AD and 91(29.1%) only RTP Of these, 57 (62.6%) have maintained complete response and 34 (37.4%) had failure response with post-RTP BCR. Results: Study of the group treated exclusively with salvage RTR Ninety-one patients were treated with salvage RTR Median follow-up was 6.4 years and median to recurrence 11 months. Post-RTP biochemical relapse-free survival (PRBRFS) was 68 +/- 7% and 30 +/- 10% in 5 to 10 years. Median PRBRFS was 7.3 years (6.3-8.3). Initial PSA (FIR: 1.08; 95% CI: 1.01-1.1 P=.02) with best PSA cut-off point PSA > 20 ng/ml (HR: 13.6; 95% CI: 2.1-86 P=.005) and PSA pre-RTP (HR: 1.9; 95% CI: 1.2-3.3; P=.009), best PSA cut-off point PSA preRTP 0.92 ng/ml (FIR: 4.5; 95% CI: 1.3-15.6; P=.01) showed independent influence in the response in the multivariate study. PRBRFS at 5 years, 81 +/- 9% versus 58 +/- 9% with initial PSA < 20 or > 20 ng/ml (P=.03). PRBRFS at 5 years, 93 +/- 5% versus 53 +/- 10% according to PSA pre-RTP <0.9 or >0.9 ng/ml (P=.02). Conclusions: In patients treated with salvage RTP after radical prostatectomy, the preoperative PSA > 20 ng/ml and PSA preRTP > 0.92 ng/ml shows an independent influence on the response. (C) 2013 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.