Prostate news article, August 2005
Postoperative Radiotherapy after Radical Prostatectomy: A Randomised Controlled Trial Article in The Lancet, August 2005 Reviewed by: Mr Joe Nariculam, MBBS, MRCS |
Local recurrence of prostate cancer after radical prostatectomy can arise in patients with cancer extending beyond the prostate capsule.
Published in the August issue of The Lancet medical journal, The European Organisation for Research and Treatment of Cancer (EORTC) initiated a randomised, multicentre trial. The trial was to test the hypothesis that immediate radiotherapy after radical prostatectomy improves progression-free survival in patients with pathological T3 stage prostate cancer who are at risk of local relapse and distant spread.
After undergoing radical retropubic prostatectomy, 503 patients were randomly assigned by researchers to a watch and wait policy, while 502 patients were assigned to a group who were given radiotherapy 16 weeks after radical prostatectomy.
Eligible patients had to have one or more pathological risk factors, including prostate capsule perforation, invasion of the seminal vesicles and positive surgical margins that would be identified in the resected prostate. The endpoint was biochemical (PSA) progression-free survival.
The median age group of patients in this study was 65years. After a follow up of 5 years, biochemical (PSA) and clinical progression-free survival was significantly improved in the patients who had been given radiotherapy following the operation.
The researchers concluded that a longterm analysis of the trial should be planned to confirm whether improvement in biochemical (PSA) and clinical-disease-free survival from immediate postoperative radiotherapy translates into survival benefit.
Michel Bolla, Hein Van Poppel, Laurence Collette
The Lancet 2005; 366: 572-578.