J Clin Oncol: Appropriate adjuvant radiotherapy after radical prostatectomy for stage pN1 prostate cancer reduces long-term mortality!

Appropriate adjuvant radiotherapy has been shown to further reduce all-cause mortality (ACM) compared with salvage radiotherapy (sRT) after early radical prostatectomy in patients with pN1 prostate cancer (PC)
.

However, it is unclear whether this finding holds true regardless of the number of positive lymph nodes (LNs) after adjusting for time-dependent use and duration of androgen deprivation therapy

A study published today in the Journal of Clinical Oncology assessed all-cause mortality with time-dependent adjuvant radiotherapy versus salvage radiotherapy as the number of positive pelvic lymph nodes increased by univariate and multivariate logistic regression analyses.
ratio is significantly reduced
.

Patients were divided into different subgroups according to the number of positive pelvic lymph nodes: 0-3, 4, ≥4

The study cohort included a total of 17,913 pT2-4N1M0 prostate cancer patients (median age, 64 years), of whom 1614 (9.
01%) were pN1 stage (412 received adjuvant radiotherapy and 340 received adjuvant androgen deprivation therapy).
)
.

After a median follow-up of 7.

All-cause mortality in patients with ≥4 pelvic-positive lymph nodes receiving different treatments

Compared with early salvage radiotherapy, adjuvant radiotherapy significantly reduced the risk of all-cause mortality in patients with prostate cancer, and with each additional notch of positive pelvic lymph nodes, adjuvant radiotherapy increased the risk of death in prostate cancer patients by 8% (adjusted hazard ratios[aHR] 0.
92, p=0.
03)
.

In patients with 4 or more pelvic-positive lymph nodes, adjuvant RT significantly reduced 7-year adjusted all-cause mortality compared with salvage RT (7.

Compared with early salvage radiotherapy, adjuvant radiotherapy significantly reduced the risk of all-cause mortality in patients with prostate cancer, and with each additional notch of positive pelvic lymph nodes, the effect of adjuvant radiotherapy in reducing the risk of death in patients with prostate cancer increased by 8% compared with early salvage radiotherapy .

All-cause mortality in patients with 1-3 pelvic-positive lymph nodes receiving different treatments

In conclusion, for patients with pN1 prostate cancer, appropriate adjuvant radiotherapy after early radical prostatectomy can reduce the risk of subsequent all-cause mortality, and the reduction effect increases with the number of positive pelvic lymph nodes.
increasingly noticeable
.

For patients with pN1 prostate cancer, appropriate adjuvant radiotherapy after early radical prostatectomy can reduce the risk of subsequent all-cause mortality, and the reduction effect is more significant with the number of positive pelvic lymph nodes
.

For patients with pN1 prostate cancer, appropriate adjuvant radiotherapy after early radical prostatectomy can reduce the risk of subsequent all-cause mortality, and the reduction effect is more significant with the number of positive pelvic lymph nodes

Original source:

Derya Tilki, et al.

Adjuvant Versus Early Salvage Radiation Therapy After Radical Prostatectomy for pN1 Prostate Cancer and the Risk of Death Leave a Comment