NEW YORK (Reuters Health) - In men with prostate cancer, follow-up radiotherapy after complete removal of the prostate (radical prostatectomy) does not improve overall or cancer-specific survival, according to a report in the March issue of BJU International.

Recent trials have suggested a benefit of follow-up (adjuvant) radiotherapy in terms of recurrence-free survival, the authors explain, but there is controversy regarding the benefits of adjuvant radiotherapy on other endpoints.

Dr. Pierre I. Karakiewicz from the University of Montreal, Quebec, Canada, and colleagues examined cause-specific survival and overall survival using data from 752 patients treated with radical prostatectomy, 118 of whom underwent adjuvant radiotherapy.

Patients who received adjuvant radiotherapy had higher pathological tumor stage, higher pathological tumor cell type, and higher rate of positive surgical margins and received hormonal therapy more frequently than did patients who did not receive adjuvant radiotherapy, the investigators report.

In unmatched analyses, they found, patients who received adjuvant radiotherapy had lower probabilities of overall survival and cancer-specific survival after radical prostatectomy than those who did not receive adjuvant radiotherapy.

However, in matched analyses, there was no statistically significant difference in overall survival and cancer-specific survival.

"Our analysis showed that adjuvant radiotherapy has no effect on overall survival and cancer-specific survival," Karakiewicz and colleagues conclude. Additional random, controlled trials are needed to confirm or disprove the benefit of adjuvant radiotherapy."

SOURCE: BJU International March 2, 2009.

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