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Trends in Cancer Research   Volumes    Volume 18 
Pelvic radiation in the management of pathological node-positive prostate cancer
Hong Zhang, Hongmei Yang, Sanjukta Bandyopadhyay, Joel Kruger, Kevin Bylund, Michael Cummings, Chunkit Fung, Deepak Sahasrahbudhe, Peter Van Veldhuizen, Adrienne Victor, Thomas Frye, Jean Joseph, Hani Rashid, Guan Wu, Edward M. Messing
Pages: 29 - 38
Number of pages: 10
Trends in Cancer Research
Volume 18 

Copyright © 2023 Research Trends. All rights reserved

The optimal management of pathological node-positive prostate cancer (pN+ Pca) following radical prostatectomy and pelvic lymph node dissection (RP+PLND) remains an area of uncertainty. While a single randomized controlled trial has demonstrated the benefits of immediate androgen deprivation therapy (ADT) post-RP+PLND, the role of pelvic radiation therapy (RT) remains inconclusive. This retrospective study aims to review our institutional experience with pN+ Pca cases, shedding light on patient outcomes. Patients with pN+ Pca treated at our institution from 2006 to 2016 were identified. Patients with ADT and RT records were further analyzed together with disease characteristics. Kaplan‒Meier analyses were used to evaluate overall survival (OS) and disease-free survival (DFS, defined as free of biochemical recurrence or clinical evidence of disease). Of the 85 patients with pN+ Pca, 69 underwent postoperative RT with a median follow-up of 92 months. Among these, 86% received concurrent ADT (median duration of 24 months), and the median time from prostatectomy to RT was 4 months. Among 16 patients treated without RT, 68.8% received ADT (median duration of 24 months) and a median follow-up of 91 months. Estimated 5-year OS and DFS for patients with and without RT were 98.6%, 87.5%, and 82.3%, 60.9%, respectively (p=0.027 and p=0.034). Among those receiving ADT, the estimated 5-year DFS was 86.1% with RT and 56.3% without RT (p=0.016). This study suggests that pelvic radiation contributes to prolonged OS in patients with pN+ Pca. The findings emphasize the potential benefits of incorporating RT into the postoperative management of this patient population.
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