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Whole pelvis radiotherapy for pathological node-positive prostate cancer

Filip Poelaert UGent, Valerie Fonteyne UGent, Piet Ost UGent, Bart De Troyer, Karel Decaestecker UGent, Gert De Meerleer UGent, PIETER DE VISSCHERE, Tom Claeys, Bert Dhondt UGent and Nicolaas Lumen UGent (2017) STRAHLENTHERAPIE UND ONKOLOGIE. 193(6). p.444-451
abstract
Purpose: The goal of this work was to investigate the oncological outcome of whole pelvis radiotherapy (wpRT) in pathologic pelvic lymph node-positive (pN1) prostate cancer (PCa), evaluate the location of relapse, and identify potential prognostic factors. Patients and methods: All patients undergoing pelvic lymph node dissection (PLND) since the year 2000 at a single tertiary care center were evaluated. A total of 154 patients with pN1 PCa were treated with wpRT (39 in an adjuvant setting) and 2-3 years of androgen deprivation therapy (ADT). Kaplan-Meier analysis was performed to estimate biochemical recurrence-free survival (bRFS), clinical progression-free survival (cPFS), and prostate cancer-specific survival (CSS). Uni- and multivariate regression analyses were performed to identify prognostic factors. Results: Estimated bRFS was 67%, cPFS was 71%, and CSS was 96% at 5 years. Median follow-up was 55 months (interquartile range 25-87). Multivariate analysis identified having only 1 positive lymph node, a shorter time between diagnosis and PLND, and older age as independent favorable prognostic factors for biochemical and clinical recurrence. The number of positive lymph nodes was prognostic for CSS (hazard ratio [HR] 1.34, 95% confidence interval 1.17-1.54) and OS (HR 1.22, 95% confidence interval 1.10-1.36). Bone metastases were the most frequent location of PCa relapse (n = 32, 64%). Conclusions: Patients with pN1 PCa treated with wpRT and 2-3 years ADT have an encouraging 5aEuroyear CSS. Understaging of the disease extent may be the most important enemy in definitive pN1 PCa treatment.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
Lymph node metastases, Prostate cancer, Radical prostatectomy, Radiotherapy, Survival analysis, RADICAL RETROPUBIC PROSTATECTOMY, ANDROGEN DEPRIVATION THERAPY, COMBINED RADIATION-THERAPY, ADJUVANT RADIOTHERAPY, HORMONAL-THERAPY, SURVIVAL, DISSECTION, LYMPHADENECTOMY, SUPPRESSION, METASTASES
journal title
STRAHLENTHERAPIE UND ONKOLOGIE
Strahlenther. Onkol.
volume
193
issue
6
pages
444 - 451
Web of Science type
Article
Web of Science id
000401893900002
ISSN
0179-7158
1439-099X
DOI
10.1007/s00066-016-1094-5
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
8505249
handle
http://hdl.handle.net/1854/LU-8505249
date created
2017-01-27 09:41:33
date last changed
2017-11-16 08:32:39
@article{8505249,
  abstract     = {Purpose: The goal of this work was to investigate the oncological outcome of whole pelvis radiotherapy (wpRT) in pathologic pelvic lymph node-positive (pN1) prostate cancer (PCa), evaluate the location of relapse, and identify potential prognostic factors. 
Patients and methods: All patients undergoing pelvic lymph node dissection (PLND) since the year 2000 at a single tertiary care center were evaluated. A total of 154 patients with pN1 PCa were treated with wpRT (39 in an adjuvant setting) and 2-3 years of androgen deprivation therapy (ADT). Kaplan-Meier analysis was performed to estimate biochemical recurrence-free survival (bRFS), clinical progression-free survival (cPFS), and prostate cancer-specific survival (CSS). Uni- and multivariate regression analyses were performed to identify prognostic factors. 
Results: Estimated bRFS was 67\%, cPFS was 71\%, and CSS was 96\% at 5 years. Median follow-up was 55 months (interquartile range 25-87). Multivariate analysis identified having only 1 positive lymph node, a shorter time between diagnosis and PLND, and older age as independent favorable prognostic factors for biochemical and clinical recurrence. The number of positive lymph nodes was prognostic for CSS (hazard ratio [HR] 1.34, 95\% confidence interval 1.17-1.54) and OS (HR 1.22, 95\% confidence interval 1.10-1.36). Bone metastases were the most frequent location of PCa relapse (n = 32, 64\%). 
Conclusions: Patients with pN1 PCa treated with wpRT and 2-3 years ADT have an encouraging 5aEuroyear CSS. Understaging of the disease extent may be the most important enemy in definitive pN1 PCa treatment.},
  author       = {Poelaert, Filip and Fonteyne, Valerie and Ost, Piet and De Troyer, Bart and Decaestecker, Karel and De Meerleer, Gert and DE VISSCHERE, PIETER and Claeys, Tom and Dhondt, Bert and Lumen, Nicolaas},
  issn         = {0179-7158},
  journal      = {STRAHLENTHERAPIE UND ONKOLOGIE},
  keyword      = {Lymph node metastases,Prostate cancer,Radical prostatectomy,Radiotherapy,Survival analysis,RADICAL RETROPUBIC PROSTATECTOMY,ANDROGEN DEPRIVATION THERAPY,COMBINED RADIATION-THERAPY,ADJUVANT RADIOTHERAPY,HORMONAL-THERAPY,SURVIVAL,DISSECTION,LYMPHADENECTOMY,SUPPRESSION,METASTASES},
  language     = {eng},
  number       = {6},
  pages        = {444--451},
  title        = {Whole pelvis radiotherapy for pathological node-positive prostate cancer},
  url          = {http://dx.doi.org/10.1007/s00066-016-1094-5},
  volume       = {193},
  year         = {2017},
}

Chicago
Poelaert, Filip, Valerie Fonteyne, Piet Ost, Bart De Troyer, Karel Decaestecker, Gert De Meerleer, PIETER DE VISSCHERE, Tom Claeys, Bert Dhondt, and Nicolaas Lumen. 2017. “Whole Pelvis Radiotherapy for Pathological Node-positive Prostate Cancer.” Strahlentherapie Und Onkologie 193 (6): 444–451.
APA
Poelaert, F., Fonteyne, V., Ost, P., De Troyer, B., Decaestecker, K., De Meerleer, G., DE VISSCHERE, P., et al. (2017). Whole pelvis radiotherapy for pathological node-positive prostate cancer. STRAHLENTHERAPIE UND ONKOLOGIE, 193(6), 444–451.
Vancouver
1.
Poelaert F, Fonteyne V, Ost P, De Troyer B, Decaestecker K, De Meerleer G, et al. Whole pelvis radiotherapy for pathological node-positive prostate cancer. STRAHLENTHERAPIE UND ONKOLOGIE. 2017;193(6):444–51.
MLA
Poelaert, Filip, Valerie Fonteyne, Piet Ost, et al. “Whole Pelvis Radiotherapy for Pathological Node-positive Prostate Cancer.” STRAHLENTHERAPIE UND ONKOLOGIE 193.6 (2017): 444–451. Print.