Adjuvant RT + ADT Associated With Improved OS in Lymph Node Positive PCa

Share this content:
Radiation treatment plus androgen deprivation therapy after radical prostatectomy was associated with an overall survival benefit.
Radiation treatment plus androgen deprivation therapy after radical prostatectomy was associated with an overall survival benefit.

Radiation treatment plus androgen deprivation therapy (ADT) after radical prostatectomy was associated with an overall survival benefit among patients with prostate cancer with lymph node involvement, according to a study published in Cancer.1

The management of prostate cancer with lymph node involvement after radical prostatectomy remains controversial. Although retrospective studies support the use of radiotherapy after extended pelvic lymph node dissection in select patients, the generalizability of this approach to practice is unclear.

To identify patients with lymph node involvement who could derive a survival benefit with adjuvant radiotherapy in combination with ADT, researchers analyzed data from 2569 patients with N1M0 prostate adenocarcinoma who underwent radical prostatectomy followed by ADT between 2003 and 2011.

Of those, 35.3% received radiotherapy. Patients were more likely to receive radiotherapy if they were younger than 65 years, were diagnosed in later years, had fewer positive lymph nodes, and had involved surgical margins (all P < .05).

The study showed that 87% of patients who received radiotherapy were alive at 5 years compared with 82% of those who did not undergo radiation treatment (P = .007).

In a propensity score analysis of 826 patients in each cohort, results demonstrated that receipt of radiotherapy was significantly associated with a 43% improvement in overall survival (hazard ratio, 1.43; 95% CI, 1.10-1.86; P = .008).

There was no association between the effect of radiotherapy on overall survival and total lymph nodes examined, lymph node ratio, total number of positive lymph nodes, margin status, prostate-specific antigen, or Gleason score.

RELATED: Second Opinions Have Little Impact on Prostate Cancer Decisions

In the absence of randomized clinical trial data, these findings may help guide therapy for this subpopulation of patients with prostate cancer. Future large prospective trials are needed to validate these results.

Reference

  1. Jegadeesh N, Liu Y, Zhang C, et al. The role of adjuvant radiotherapy in pathologically lymph node positive prostate cancer. Cancer. 2016 Nov 8. doi: 10.1002/cncr.30373 [Epub ahead of print]

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs

Sign Up for Free e-newsletters