La radiologia medica

, Volume 123, Issue 8, pp 631–637 | Cite as

Prognostic impact of nodal relapse in definitive prostate-only irradiation

  • Mauro Loi
  • Luca Incrocci
  • Isacco Desideri
  • Pierluigi Bonomo
  • Beatrice Detti
  • Gabriele Simontacchi
  • Daniela Greto
  • Emanuela Olmetto
  • Giulio Francolini
  • Icro Meattini
  • Lorenzo Livi



Whole pelvic irradiation in prostate cancer patients might prevent metastatic spread of cancer cells through lymphatic drainages in patients eligible for definitive radiotherapy, but its use has declined in the last decades in favor of prostate-only irradiation (POI). The aim of our study is to assess the incidence of pelvic lymph nodal relapse and outcome in prostate cancer patients receiving POI.

Materials and methods

Data from 207 consecutive patients were collected. Clinical and treatment variables were collected. Biochemical relapse-free survival (BRFS), pelvic nodal relapse-free survival (PNRFS), distant metastasis-free survival (DMFS), disease-specific survival (DSS) and overall survival (OS) were calculated; analysis of prognostic variables was performed.


Five-year BRFS, PNRFS, DMFS, DSS and OS were, respectively, 90, 98, 96, 97 and 91%. On multivariate analysis, independent negative predictors of BRFS were Gleason score ≥ 7 (HR: 3.25) and PSA nadir ≥ 0.08 (HR: 4.86). Pelvic nodal relapse was not correlated to impaired outcome.


Lymph nodal pelvic relapse occurs in 2% of patients at 5 years and does not correlate with impaired outcome, suggesting the lack of theoretical benefit of a prophylactic nodal irradiation. Tumor biology and response to treatment are the main determinants of outcome.


Prostate cancer Definitive radiotherapy Whole pelvic irradiation Prostate-only irradiation 



This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

All the authors listed (Mauro Loi, Luca Incrocci, Isacco Desideri, Pierluigi Bonomo, Beatrice Detti, Gabriele Simontacchi, Daniela Greto, Emanuela Olmetto, Giulio Francolini, Icro Meattini, Lorenzo Livi) report no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants.


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Copyright information

© Italian Society of Medical Radiology 2018

Authors and Affiliations

  • Mauro Loi
    • 1
    • 2
  • Luca Incrocci
    • 2
  • Isacco Desideri
    • 1
  • Pierluigi Bonomo
    • 1
  • Beatrice Detti
    • 1
  • Gabriele Simontacchi
    • 1
  • Daniela Greto
    • 1
  • Emanuela Olmetto
    • 1
  • Giulio Francolini
    • 1
  • Icro Meattini
    • 1
  • Lorenzo Livi
    • 1
  1. 1.Radiation Oncology UnitUniversity of FlorenceFlorenceItaly
  2. 2.Radiotherapy DepartmentErasmus MC HospitalRotterdamThe Netherlands

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