Salvage RT was administered at a total dose of 60–70 Gy (median 66 Gy), delivered in daily fractional dose of 1.8–2.0 Gy. Prostate-specific antigen (PSA) levels were measured every 2–3 months during the first year, every 6 months in the second year, and then at least once per year following RP and salvage RT. Of the 212 study participants, 124 (58.5%) received androgen deprivation therapy (ADT) concomitantly with the salvage RT.

None of the patients showed any clinical evidence of distant metastases before they underwent salvage RT.

A total of 212 patients who underwent salvage RT were included in our study, and those who were administered neoadjuvant or adjuvant hormonal therapy were excluded from the study. Of these patients, 363 (19.2%) experienced BCR.

With the approval of the institutional review board at the Seoul National University Bundang Hospital (IRB No.: B-1404/248-108), we reviewed the records of 1893 PCa patients who underwent RP at our institution between November 2003 and December 2012. Thus, we investigated the outcomes of patients who underwent salvage RT for biochemical failure following RP at our institution and sought to identify prognostic factors for such men. Efforts to identify useful predictors, clinical or pathological, to select men at higher risk of failure after salvage RT would be critical for improving outcomes in salvage setting. Accordingly, the identification of patients at higher risk of adverse outcome following salvage RT would be clinically important since such patients may benefit from adjuvant or more extensive forms of salvage therapy. Although salvage RT for BCR following RP has been reported to decrease the risk of adverse outcome, a significant proportion of patients who underwent salvage RT demonstrate biochemical failure with 4- or 5-year biochemical disease-free survival rates after RT ranging from 46–60%. įor patients with suspected local failure following RP, external beam radiotherapy (RT) is a widely performed as salvage therapy. The median intervals from biochemical failure to distant metastasis and from metastasis to death have been reported to be about 8 years and 5 years, respectively. Certainly, postoperative biochemical recurrence (BCR) is associated with increased risk of distant metastasis and death from cancer. A considerable proportion of men undergoing RP would eventually need additional treatment. However, published data have shown that up to 40% of patients undergoing RP may eventually experience biochemical failure with long-term follow-up. The technique of RP continues to be refined with emergence of robotic approach. Since Walsh's introduction of anatomical approach, radical prostatectomy (RP) has been widely performed as a definitive treatment for clinically localized prostate cancer (PCa).

Psa doubling time survival rate