Survival after biochemical failure in prostate cancer treated with radiotherapy: Spanish Registry of Prostate Cancer (RECAP) database outcomes

• C. González-San Segundo ^[1] ; J. Jové ^[10] ; A. Zapatero ^[2] ; J. Pastor-Peidro ^[3] ; M. L. Vázquez ^[11] ; M. Casaña ^[4] ; J. L. Mengual ^[4] ; A. Gómez-Caamaño ^[12] ; A. Gómez-Iturriaga ^[5] ; C. Vallejo ^[6] ; I. Henríquez ^[13] ; J. L. Muñoz-García ^[14] ; J. Clemente ^[4] ; M. Porras ^[15] ; E. Collado ^[7] ; G. Ossola ^[16] ; E. Villafranca ^[8] ; M. A. Cabeza ^[9] ; J. López-Torrecilla ^[3]
  1. [1] Hospital General Universitario Gregorio Marañón

     Hospital General Universitario Gregorio Marañón

     Madrid, España

     
  2. [2] Hospital Universitario de la Princesa

     Hospital Universitario de la Princesa

     Madrid, España

     
  3. [3] Hospital General Universitario de Valencia

     Hospital General Universitario de Valencia

     Valencia, España

     
  4. [4] Instituto Valenciano de Oncologia

     Instituto Valenciano de Oncologia

     Valencia, España

     
  5. [5] Instituto de Investigación Sanitaria Biocruces Bizkaia

     Instituto de Investigación Sanitaria Biocruces Bizkaia

     Barakaldo, España

     
  6. [6] Hospital Ramón y Cajal

     Hospital Ramón y Cajal

     Madrid, España

     
  7. [7] Hospital Universitario La Fe

     Hospital Universitario La Fe

     Valencia, España

     
  8. [8] Gobierno de Navarra

     Gobierno de Navarra

     Pamplona, España

     
  9. [9] Hospital Universitario 12 de Octubre

     Hospital Universitario 12 de Octubre

     Madrid, España

     
  10. [10] Hospital Universitario Germans Trias i Pujol
  11. [11] Hospital Meixoeiro
  12. [12] Hospital Clínico Universitario Santiago de Compostela
  13. [13] Hospital Universitario San Joan Reus
  14. [14] Hospital Infanta Cristina Badajoz
  15. [15] Hospital Universitario Virgen de la Arrixaca
  16. [16] Fundación Rioja Salud

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 21, Nº. 8 (August), 2019, págs. 1044-1051
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Introduction The clinical course in patients with prostate cancer (PCa) after biochemical failure (BF) has received limited attention. This study analyzes survival time from recurrence, patterns of progression, and the efficacy of salvage therapies in patients treated with radical or postoperative radiotherapy (RT).

    Methods This is a multicenter retrospective comparative study of 1135 patients diagnosed with BF and treated with either radical (882) or postoperative (253) RT. Data correspond to the RECAP database. Clinical, tumor, and therapeutic characteristics were collected. Descriptive statistics, survival estimates, and comparisons of survival rates were calculated.

    Results Time to BF from initial treatment (RT or surgery) was higher in irradiated patients (51 vs 37 months). At a median follow-up of 102 months (14–254), the 8-year cause-specific survival (CSS) was 80.5%, without significant differences between the radical (80.1%) and postoperative (83.4%) RT groups. The 8-year metastasis-free survival rate was 57%. 173 patients (15%) died of PCa and 29 (2.5%) of a second cancer. No salvage therapy was given in 15% of pts. Only 5.5% of pts who underwent radical RT had local salvage treatment and 71% received androgen deprivation (AD) ± chemotherapy. The worst outcomes were in patients who developed metastases after BF (302 pts; 26.5%) and in cases with a Gleason > 7.

    Conclusions In PCa treated with radiotherapy, median survival after BF is relatively long. In this sample, no differences in survival rates at 8-years have been found, regardless of the time of radiotherapy administered. AD was the most common treatment after BF. Metastases and high Gleason score are adverse variables. To our knowledge, this is the first study to compare outcomes after BF among patients treated with primary RT vs. those treated with postoperative RT and to evaluate recurrence patterns, treatments administered, and causes of death. The results allow avoiding overtreatment, improving quality of life, without negatively affecting survival.