PSA based review of adjuvant and salvage radiation therapy vs. observation in postoperative prostate cancer patients

Int J Cancer. 2000 Feb 20;90(1):29-36.


Because of the uncertainties regarding the efficacy of postoperative radiation therapy for early prostate cancer, treatment strategies following radical prostatectomy include: (1) observation alone in high-risk patients, (2) adjuvant radiation therapy (PSA undetectable) in high-risk patients, or (3) salvage radiation therapy for biochemical and clinical recurrence. Fifty-two patients treated with postoperative radiation therapy in either an adjuvant setting (13) or for salvage (39) were retrospectively reviewed. The actuarial biochemical disease-free survival (bNED) rates following radiation therapy were calculated using the life-table method. Univariate and multi variate analyses were used to define the clinical factors that predict biochemical failure following postoperative radiation therapy. In addition, the bNED survival rate for 36 high-risk surgery patients who were simply observed following prostatectomy was determined. The 3-year bNED survival rate for the adjuvant radiation group was 85% compared with 27% for salvage radiation and 43% for the observation group. These results are statistically significant. Factors that predict biochemical failure following postoperative radiation therapy include preoperative PSA level, pre-radiation therapy PSA level, and seminal vesicle involvement. At our institutions, adjuvant radiation therapy was a superior strategy compared with either observation alone or salvage radiation therapy for high-risk postoperative prostate cancer patients. Int. J. Cancer (Radiat. Oncol. Invest.) 90, 29-36 (2000).

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Analysis of Variance
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Proteins / blood*
  • Neoplasm Recurrence, Local / blood*
  • Postoperative Period
  • Prostate-Specific Antigen / blood*
  • Prostatectomy
  • Prostatic Neoplasms / blood*
  • Prostatic Neoplasms / radiotherapy*
  • Prostatic Neoplasms / surgery
  • Radiotherapy, Adjuvant
  • Regression Analysis
  • Retrospective Studies
  • Salvage Therapy
  • Survival Rate


  • Neoplasm Proteins
  • Prostate-Specific Antigen