Current status and outcomes of patients developing PSA recurrence after prostatectomy who were treated with salvage radiotherapy: a JROSG surveillance study

J Radiat Res. 2015 Jul;56(4):750-6. doi: 10.1093/jrr/rrv027. Epub 2015 Apr 24.


The conditions and outcomes of Japanese patients with prostate cancer who developed PSA failure after radical prostatectomy (RP), and who were treated via salvage radiotherapy (S-RT), were surveyed. Clinical data on S-RT were gathered in questionnaires completed by facilities participating in the Japanese Radiation Oncology Study Group. S-RT was defined as external-beam radiotherapy delivered to the prostate beds of patients with prostate cancer who had eventually developed PSA failure, although their PSA values had at one stage attained levels <0.2 ng/ml following RP. Hormonal therapy was combined with S-RT in ∼40% of cases. Outcomes were evaluated in 186 cases treated via S-RT alone. The nadir PSA level after RP, and the level upon initiation of S-RT, were 0.0135 ng/ml and 0.292 ng/ml, respectively. The median period between RP and S-RT was 18.6 months. The median follow-up period was 58 months. The 5-year PSA recurrence-free survival (PRFS) and clinical failure-free survival (CFFS) rates were 50.1% (95% CI: 42.8-57.9%) and 90.1% (95% CI: 86.4-95.7%), respectively. PRFS was significantly superior in patients with PSA values ≤0.3 ng/ml upon initiation of S-RT than in those with PSA values >0.3 ng/ml (57.5% vs 40.5%, P = 0.027). In Japan, hormonal therapy is combined with S-RT in ∼40% of cases. The 5-year PRFS and CFFS rates of cases treated via S-RT alone were 50.1% and 90.1%, respectively. A PSA value of 0.3 ng/ml served as a significant cut-off for prediction of PRFS.

Keywords: PSA recurrence; prostate cancer; radical prostatectomy; salvage radiotherapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood
  • Disease-Free Survival
  • Humans
  • Japan / epidemiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / prevention & control*
  • Postoperative Period
  • Prostate-Specific Antigen / blood
  • Prostatectomy / mortality*
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / mortality*
  • Prostatic Neoplasms / therapy*
  • Radiotherapy, Adjuvant / mortality*
  • Radiotherapy, Conformal / mortality
  • Retrospective Studies
  • Salvage Therapy / mortality*
  • Sentinel Surveillance
  • Survival Rate
  • Treatment Outcome


  • Biomarkers, Tumor
  • Prostate-Specific Antigen