Functional and oncological outcomes of salvage external beam radiotherapy following robot-assisted radical prostatectomy in a Canadian cohort
Khaled Ajib, Marc Zanaty, Mansour Alnazari, Emad Rajih, Pierre-Alain Hueber, Mila Mansour, Roger Valdivieso, Cristina Negrean, Pierre I Karakiewicz, Daniel Taussky, Guila Delouya, Assaad El-Hakim, Kevin C Zorn, Khaled Ajib, Marc Zanaty, Mansour Alnazari, Emad Rajih, Pierre-Alain Hueber, Mila Mansour, Roger Valdivieso, Cristina Negrean, Pierre I Karakiewicz, Daniel Taussky, Guila Delouya, Assaad El-Hakim, Kevin C Zorn
Abstract
Introduction: We sought to determine the impact of salvage radio-therapy (SRT) on oncological and functional outcomes of patients with prostate cancer after biochemical recurrence (BCR) following robot-assisted radical prostatectomy (RARP).
Methods: Data of 70 patients with prostate cancer treated with SRT after developing BCR were retrospectively analyzed from a prospectively collected RARP database of 740 men. Oncological (prostate-specific antigen [PSA]) and functional (pads/day, International Prostate Symptom Score [IPSS], and Sexual Health Inventory for Men [SHIM]) outcomes were reported at six, 12, and 24 months after RT and adjusted for pre-SRT status.
Results: Men who underwent SRT had a mean age, PSA, and time from radical prostatectomy (RP) to RT of 61.8 years (60.1-63.6), 0.5 ng/ml (0.2-0.8), and 458 days (307-747), respectively. Freedom from biochemical failure (FFBF) post-SRT, defined as a PSA nadir <0.2 ng/mL, was observed in 89%, 93%, and 81%, at six, 12, and 24 months, respectively. Undetectable PSA was observed in 14%, 35%, and 40% at the same time points, respectively. There was no significant difference in urinary continence post-SRT (p=0.56). Rate of strict continence (0 pads/day) was 71% at 24 months compared to 78% pre-SRT. Mean IPSS at six, 12, and 24 months was 3.4, 3.6, and 3.6, respectively compared to pre-RT score of 3.3 (p=0.61). The mean SHIM score pre-SRT was comparable at all time points following treatment (p=0.86).
Conclusions: In this unique Canadian experience, it appears that early SRT is highly effective for the treatment of BCR following RARP with little impact on urinary continence and potency outcomes.
Conflict of interest statement
Competing interests: Dr. Taussky has received grants/honoraria from Bayer and Sanofi. Dr. Zorn has been a consultant for Boston Scientific. The remaining authors report no competing personal or financial interests.
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Source: PubMed