Prognostic factors in postoperative radiotherapy for prostate cancer – tertiary center experience.
Prognostic factors in postoperative prostate cancer irradiation.
To analyze the prognostic factors in postoperative prostate cancer irradiation and develop a nomogram for disease-free survival.
This retrospective study included 236 consecutive prostate cancer patients who had radical prostatectomy followed by radiotherapy at a single tertiary institution between 2009 and 2014. The main outcome was disease-free survival analyzed through uni- and multivariable analysis, Kaplan-Meier curves, log-rank testing, recursive partitioning analysis, and nomogram development.
The median follow up was 62.3 (IQR 38.1-79) months. The independent clinical factors associated with increased risk of recurrence or progression in the MVA were PSA level before radiotherapy, pT3 characteristic, and local failure as salvage indication. The value of PSA nadir had a significant impact on the risk of biochemical failure.
Biochemical control and disease-free survival were significantly different depending on treatment indication (p<0.0001).
The recursive partitioning analysis highlighted the importance of the PSA level before RT, Gleason Grade Group, PSA nadir, and local failure as a treatment indication.
Finally, the nomogram for DFS was developed and is available online at https://apps.konsta.com.pl/app/prostate-salvage-dfs/.
The Pre-RT PSA level, pT3 characteristic and local failure as salvage indication are pivotal prognostic factors associated with increased risk of recurrence or progression. The Gleason Grade Group of 4-5 and PSA nadir value allow for further risk stratification.
The treatment outcomes in postoperative prostate cancer irradiation are significantly different depending on treatment indication.
An online nomogram comprising of both pre-treatment and current data was developed allowing for visualization of changes in prognosis depending on clinical data.
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