In a nutshell
The present study evaluated whether patients with stage III prostate cancer (PCa) who underwent radical prostatectomy (RP) would benefit from further radiotherapy (RT), as opposed to the "wait and see" approach. There was a 21% increase in survival with no cancer progression in patients who received additional RT.
Some background
Stage III PCa means that the cancer has spread beyond the prostate gland, but has not yet reached the bladder, rectum (the lowest part of the large bowel), lymph nodes or distant organs. These patients usually benefit from RP (surgical removal of the cancer along with the prostate gland and some healthy tissue around it). Usually if all the cancer has been removed the blood PSA (prostate specific antigen – a protein specific to the prostate gland whose levels rise in prostate disease) levels drop to an undetectable level. Some patients may also benefit from additional RT to make sure the cancer has been completely removed. However, RP and RT together may have serious side effects such as bladder, bowel or sexual problems. Therefore, some patients with undetectable PSA levels after RP can be regularly monitored for signs of a recurrence (return of the cancer). This is called the “wait and see” approach (also known as active surveillance).
Methods & findings
The bottom line
In this study, patients with stage III PCa who received RT after RP had a 21% increase in PFS compared to those who were closely monitored. Patients with more advanced cancer (Gleason score > 6) and PSM benefited the most from the combined approach.
The fine print
Only cases with stage III PCa with or without PSM were included in this study so it is not certain whether this approach would be beneficial to other PCa patients.
Published By :
European Urology
Date :
Mar 17, 2013
