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Lack of survival benefit of post-operative radiation therapy in prostate cancer patients with positive lymph nodes

Prostate Cancer and Prostatic Diseases volume 10, pages 185–188 (2007)Cite this article

Abstract

Randomized data from SWOG 8794 and EORTC 22911 confirm the benefit of post-operative radiation therapy (RT) for selected patients with pT3 prostate cancer (CaP) after radical prostatectomy (RP). However, data regarding the potential benefit of RT for patients post-RP with positive lymph node (+LN) involvement are limited. We analyzed the Surveillance Epidemiology End Results (SEER) registry for population-based data on efficacy of post-operative RT for +LN patients after RP. As LN data have only been captured by SEER since 1988, we analyzed data for 1988–1992, with specific attention to 10-year relative survival (defined as observed survival divided by the survival of a gender-, age- and race-matched population cohort without disease). Specifically analyzed were data for 1921 patients with nonmetastatic prostate cancer who underwent surgery alone, or surgery followed by RT, and who had +LNs documented. SEER does not code the interval between surgery and RT, so the ratio of patients receiving salvage versus adjuvant therapy is unknown. Using follow-up data through 2002, post-diagnosis survival was examined by number of +LNs. There was no significant relative survival benefit for +LN patients receiving post-operative RT (χ2P=0.270). These data do not support routine use of post-operative RT for patients with +LNs in the surgical specimen.

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Acknowledgements

Dr Johnstone and Dr Assikis are Georgia Cancer Coalition Distinguished Cancer Scholars, supported in part by the Georgia Cancer Coalition. Dr Johnstone is supported in part by NCMHD Grant 5P60-MD000525. Selected for podium presentation at the 92nd Scientific Assembly and Annual Meeting of the Radiological Society of North America, Chicago, 29 November 2006.

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Authors and Affiliations

  1. Radiation Oncology Department, Emory University School of Medicine, Atlanta, GA, USA

    P A S Johnstone

  2. Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA

    P A S Johnstone & V Assikis

  3. Rollins School of Public Health, Emory University, Atlanta, GA, USA

    M Goodman & K C Ward

  4. Georgia Center for Cancer Statistics, Atlanta, GA, USA

    K C Ward

  5. Clinical Investigation Department, Naval Medical Center San Diego, San Diego, CA, USA

    R H Riffenburgh

  6. Urology Department, Emory University School of Medicine, Atlanta, GA, USA

    V Master

  7. Urology Department, Grady Medical Center, Atlanta, GA, USA

    V Master

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  1. P A S Johnstone
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  3. M Goodman
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Correspondence to P A S Johnstone.

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Johnstone, P., Assikis, V., Goodman, M. et al. Lack of survival benefit of post-operative radiation therapy in prostate cancer patients with positive lymph nodes. Prostate Cancer Prostatic Dis 10, 185–188 (2007). https://doi.org/10.1038/sj.pcan.4500940

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  • DOI: https://doi.org/10.1038/sj.pcan.4500940

Keywords

  • prostate neoplasms
  • prostatectomy
  • lymph nodes
  • SEER

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