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Adjuvant Versus Early Salvage Radiation Therapy After Radical Prostatectomy for pN1 Prostate Cancer and the Risk of Death

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Adjuvant Versus Early Salvage Radiation Therapy After Radical Prostatectomy for pN1 Prostate Cancer and the Risk of Death. / Tilki, Derya; Chen, Ming-Hui; Wu, Jing; Huland, Hartwig; Graefen, Markus; D'Amico, Anthony V.

in: J CLIN ONCOL, Jahrgang 40, Nr. 20, 10.07.2022, S. 2186-2192.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Tilki, D, Chen, M-H, Wu, J, Huland, H, Graefen, M & D'Amico, AV 2022, 'Adjuvant Versus Early Salvage Radiation Therapy After Radical Prostatectomy for pN1 Prostate Cancer and the Risk of Death', J CLIN ONCOL, Jg. 40, Nr. 20, S. 2186-2192. https://doi.org/10.1200/JCO.21.02800

APA

Tilki, D., Chen, M-H., Wu, J., Huland, H., Graefen, M., & D'Amico, A. V. (2022). Adjuvant Versus Early Salvage Radiation Therapy After Radical Prostatectomy for pN1 Prostate Cancer and the Risk of Death. J CLIN ONCOL, 40(20), 2186-2192. https://doi.org/10.1200/JCO.21.02800

Vancouver

Tilki D, Chen M-H, Wu J, Huland H, Graefen M, D'Amico AV. Adjuvant Versus Early Salvage Radiation Therapy After Radical Prostatectomy for pN1 Prostate Cancer and the Risk of Death. J CLIN ONCOL. 2022 Jul 10;40(20):2186-2192. https://doi.org/10.1200/JCO.21.02800

Bibtex

@article{7cc30ff7a6e94cb59f49c18286c68b4a,
title = "Adjuvant Versus Early Salvage Radiation Therapy After Radical Prostatectomy for pN1 Prostate Cancer and the Risk of Death",
abstract = "PURPOSE: An association with a reduction in the risk of all-cause mortality (ACM) and the use of adjuvant as compared with early postradical prostatectomy salvage radiation therapy (sRT) in men with pN1 prostate cancer (PC) has been observed. Yet, whether this finding applies irrespective of the number of positive lymph nodes (LNs) after adjusting for the time-dependent use and duration of androgen deprivation therapy is unknown and is addressed in the current study.METHODS: Univariable and multivariable Cox regression was used to evaluate whether the ACM risk ratio for time-dependent use of adjuvant versus early sRT per unit increase in positive pelvic LNs was significantly reduced. Adjusted ACM estimates were calculated among men who received adjuvant, early salvage, or no RT stratified by one to three or four or more positive pelvic LNs.RESULTS: After a median follow-up of 7.02 years, 986 (5.50%) men died, with 223 (22.62%) of PC. Adjuvant compared with early sRT was associated with a significantly lower ACM risk per unit increase in positive pelvic LNs (adjusted hazard ratio: 0.92; 95% CI, 0.85 to 0.99; P = .03). A significant difference in the 7-year adjusted ACM estimates favoring aRT versus early sRT was observed in men with four or more positive LNs (7.74% v 23.36%) in that the 95% CI for the 15.62% difference (5.90 to 25.35) excluded 0.00, but this was not true for men with 1-3 positive LNs (14.27% v 13.89%; 95% CI for the 0.38% difference [-7.02 to 7.79]).CONCLUSION: Adjuvant compared with early sRT in men with pN1 PC was associated with a decreased ACM risk, and this reduction increased with each additional positive pelvic LN.",
keywords = "Androgen Antagonists, Humans, Male, Prostate/pathology, Prostate-Specific Antigen, Prostatectomy, Prostatic Neoplasms/pathology, Radiotherapy, Adjuvant, Salvage Therapy",
author = "Derya Tilki and Ming-Hui Chen and Jing Wu and Hartwig Huland and Markus Graefen and D'Amico, {Anthony V}",
year = "2022",
month = jul,
day = "10",
doi = "10.1200/JCO.21.02800",
language = "English",
volume = "40",
pages = "2186--2192",
journal = "J CLIN ONCOL",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "20",

}

RIS

TY - JOUR

T1 - Adjuvant Versus Early Salvage Radiation Therapy After Radical Prostatectomy for pN1 Prostate Cancer and the Risk of Death

AU - Tilki, Derya

AU - Chen, Ming-Hui

AU - Wu, Jing

AU - Huland, Hartwig

AU - Graefen, Markus

AU - D'Amico, Anthony V

PY - 2022/7/10

Y1 - 2022/7/10

N2 - PURPOSE: An association with a reduction in the risk of all-cause mortality (ACM) and the use of adjuvant as compared with early postradical prostatectomy salvage radiation therapy (sRT) in men with pN1 prostate cancer (PC) has been observed. Yet, whether this finding applies irrespective of the number of positive lymph nodes (LNs) after adjusting for the time-dependent use and duration of androgen deprivation therapy is unknown and is addressed in the current study.METHODS: Univariable and multivariable Cox regression was used to evaluate whether the ACM risk ratio for time-dependent use of adjuvant versus early sRT per unit increase in positive pelvic LNs was significantly reduced. Adjusted ACM estimates were calculated among men who received adjuvant, early salvage, or no RT stratified by one to three or four or more positive pelvic LNs.RESULTS: After a median follow-up of 7.02 years, 986 (5.50%) men died, with 223 (22.62%) of PC. Adjuvant compared with early sRT was associated with a significantly lower ACM risk per unit increase in positive pelvic LNs (adjusted hazard ratio: 0.92; 95% CI, 0.85 to 0.99; P = .03). A significant difference in the 7-year adjusted ACM estimates favoring aRT versus early sRT was observed in men with four or more positive LNs (7.74% v 23.36%) in that the 95% CI for the 15.62% difference (5.90 to 25.35) excluded 0.00, but this was not true for men with 1-3 positive LNs (14.27% v 13.89%; 95% CI for the 0.38% difference [-7.02 to 7.79]).CONCLUSION: Adjuvant compared with early sRT in men with pN1 PC was associated with a decreased ACM risk, and this reduction increased with each additional positive pelvic LN.

AB - PURPOSE: An association with a reduction in the risk of all-cause mortality (ACM) and the use of adjuvant as compared with early postradical prostatectomy salvage radiation therapy (sRT) in men with pN1 prostate cancer (PC) has been observed. Yet, whether this finding applies irrespective of the number of positive lymph nodes (LNs) after adjusting for the time-dependent use and duration of androgen deprivation therapy is unknown and is addressed in the current study.METHODS: Univariable and multivariable Cox regression was used to evaluate whether the ACM risk ratio for time-dependent use of adjuvant versus early sRT per unit increase in positive pelvic LNs was significantly reduced. Adjusted ACM estimates were calculated among men who received adjuvant, early salvage, or no RT stratified by one to three or four or more positive pelvic LNs.RESULTS: After a median follow-up of 7.02 years, 986 (5.50%) men died, with 223 (22.62%) of PC. Adjuvant compared with early sRT was associated with a significantly lower ACM risk per unit increase in positive pelvic LNs (adjusted hazard ratio: 0.92; 95% CI, 0.85 to 0.99; P = .03). A significant difference in the 7-year adjusted ACM estimates favoring aRT versus early sRT was observed in men with four or more positive LNs (7.74% v 23.36%) in that the 95% CI for the 15.62% difference (5.90 to 25.35) excluded 0.00, but this was not true for men with 1-3 positive LNs (14.27% v 13.89%; 95% CI for the 0.38% difference [-7.02 to 7.79]).CONCLUSION: Adjuvant compared with early sRT in men with pN1 PC was associated with a decreased ACM risk, and this reduction increased with each additional positive pelvic LN.

KW - Androgen Antagonists

KW - Humans

KW - Male

KW - Prostate/pathology

KW - Prostate-Specific Antigen

KW - Prostatectomy

KW - Prostatic Neoplasms/pathology

KW - Radiotherapy, Adjuvant

KW - Salvage Therapy

U2 - 10.1200/JCO.21.02800

DO - 10.1200/JCO.21.02800

M3 - SCORING: Journal article

C2 - 35290082

VL - 40

SP - 2186

EP - 2192

JO - J CLIN ONCOL

JF - J CLIN ONCOL

SN - 0732-183X

IS - 20

ER -