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

  • C. González-San SegundoEmail author
  • J. Jové
  • A. Zapatero
  • J. Pastor-Peidro
  • M. L. Vázquez
  • M. Casaña
  • J. L. Mengual
  • A. Gómez-Caamaño
  • A. Gómez-Iturriaga
  • C. Vallejo
  • I. Henríquez
  • J. L. Muñoz-García
  • J. Clemente
  • M. Porras
  • E. Collado
  • G. Ossola
  • E. Villafranca
  • M. A. Cabeza
  • J. López-Torrecilla
Research Article

Abstract

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.

Keywords

Prostate cancer Biochemical failure Radiotherapy Survival rate Salvage therapy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any experimental studies with human participants or animals performed by any of the authors. The clinical data review was approved by the Clinical Research Ethics Committees at each centre.

Informed consent

For this type of study formal consent is not required.

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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2019

Authors and Affiliations

  • C. González-San Segundo
    • 1
    Email author return OK on get
  • J. Jové
    • 2
  • A. Zapatero
    • 3
  • J. Pastor-Peidro
    • 4
  • M. L. Vázquez
    • 5
  • M. Casaña
    • 6
  • J. L. Mengual
    • 6
  • A. Gómez-Caamaño
    • 7
  • A. Gómez-Iturriaga
    • 8
  • C. Vallejo
    • 9
  • I. Henríquez
    • 10
  • J. L. Muñoz-García
    • 11
  • J. Clemente
    • 12
  • M. Porras
    • 13
  • E. Collado
    • 14
  • G. Ossola
    • 15
  • E. Villafranca
    • 16
  • M. A. Cabeza
    • 17
  • J. López-Torrecilla
    • 4
  1. 1.HGU Gregorio MarañónMadridSpain
  2. 2.Hospital Universitario Germans Trias i PujolBadalonaSpain
  3. 3.HU de la PrincesaMadridSpain
  4. 4.Consorcio Hospital General Universitario de ValenciaValenciaSpain
  5. 5.Hospital MeixoeiroVigoSpain
  6. 6.Fundación Instituto Valenciano de OncologíaValenciaSpain
  7. 7.Hospital Clínico UniversitarioSantiago de CompostelaSpain
  8. 8.Hospital Universitario CrucesBaracaldoSpain
  9. 9.Hospital Universitario Ramón y CajalMadridSpain
  10. 10.Hospital Universitario San JoanReusSpain
  11. 11.Hospital Infanta CristinaBadajozSpain
  12. 12.Fundación Instituto Valenciano de OncologiaAlcoySpain
  13. 13.Hospital Universitario Virgen de la ArrixacaMurciaSpain
  14. 14.Hospital Universitario La FéValenciaSpain
  15. 15.Fundación Rioja SaludLa RiojaSpain
  16. 16.Hospital de NavarraPamplonaSpain
  17. 17.Hospital Universitario 12 de OctubreMadridSpain

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