Pd57-10 Age-Dependent Effect of Early Salvage Radiotherapy for Biochemical Recurrence in Prostate Cancer Patients Treated With Radical Prostatectomy

You have accessJournal of UrologyProstate Cancer: Localized: Radiation Therapy (PD57)1 May 2024PD57-10 AGE-DEPENDENT EFFECT OF EARLY SALVAGE RADIOTHERAPY FOR BIOCHEMICAL RECURRENCE IN PROSTATE CANCER PATIENTS TREATED WITH RADICAL PROSTATECTOMY Antony Pellegrino, Francesco Barletta, Giorgio Gandaglia, Simone Scuderi, Pietro Scilipoti, Mattia Longoni, Armando Stabile, Donato Cannoletta, Leonardo Quarta, Elio Mazzone, Alfonso Santangelo, Paolo Zaurito, Alessandro Viti, Riccardo Leni, Giuseppe Ottone Cirulli, Vito Cucchiara, Daniele Robesti, Francesco Montorsi, and Alberto Briganti Antony PellegrinoAntony Pellegrino , Francesco BarlettaFrancesco Barletta , Giorgio GandagliaGiorgio Gandaglia , Simone ScuderiSimone Scuderi , Pietro ScilipotiPietro Scilipoti , Mattia LongoniMattia Longoni , Armando StabileArmando Stabile , Donato CannolettaDonato Cannoletta , Leonardo QuartaLeonardo Quarta , Elio MazzoneElio Mazzone , Alfonso SantangeloAlfonso Santangelo , Paolo ZauritoPaolo Zaurito , Alessandro VitiAlessandro Viti , Riccardo LeniRiccardo Leni , Giuseppe Ottone CirulliGiuseppe Ottone Cirulli , Vito CucchiaraVito Cucchiara , Daniele RobestiDaniele Robesti , Francesco MontorsiFrancesco Montorsi , and Alberto BrigantiAlberto Briganti View All Author Informationhttps://doi.org/10.1097/01.JU.0001008808.16085.aa.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Guidelines recommend early salvage radiotherapy (eSRT) for prostate cancer (PCa) patients who experience biochemical recurrence (BCR) after radical prostatectomy (RP). However, considering the natural history of treated PCa, it might be argued that older patients derive a lower benefit from additional treatment after RP compared to their younger counterparts. Our study aims to investigate the influence of age on the impact of eSRT in patients with BCR. METHODS: Overall, 794 PCa patients experiencing BCR after RP without adjuvant therapies at a single center from 1990 to 2023 were included. BCR was defined as 2 consecutive PSA ≥0.2 after RP. We focused on men treated with eSRT at PSA values ≤0.5. Kaplan-Meier (KM) plots depicted time to clinical recurrence (CR) at radiological imaging. In multivariable Cox-regression (MCR) models adjustment variables consisted of pT stage (pT2-3a vs pT3b-4), pN stage (pN0/x vs pN1), ISUP grade group (1-3 vs 4-5), age at eSRT, eSRT and salvage androgen deprivation therapy use. The relationship between age at eSRT and eSRT was explored using LOWESS function. RESULTS: Median age at eSRT was 70 years (65-75). A total of 510 (64%) patients received eSRT for BCR. In KM plots 10-yr CR-free rates according to eSRT vs no eSRT were 80 vs 63%. In MCR models, both eSRT (HR 0.6, 95%CI 0.4-0.9, p=0.005) and age at eSRT (HR 0.95, 95%CI 0.92-0.98, p=0.001) were predictors of CR. At interaction analysis, eSRT effect varied according to age at eSRT (p=0.04). Lowess plot showed a non-linear correlation between eSRT and age at eSRT, where a significant decrease in eSRT protective effect could be observed at approximately 75 years. After stratification according to age at eSRT (<75 vs ≥75 years), eSRT confirmed its independent predictor status (HR 0.6, 95%CI 0.4-0.8, p=0.01) in the younger patients group (n=589; 74%). Conversely, in older patients (n=205; 26%) eSRT failed to achieve independent predictor status for lower CSM (HR 0.9, 95%CI 0.4-1.6, p=0.7). CONCLUSIONS: The protective effect of eSRT is inversely associated with age at eSRT and not all patients older than 75 would benefit from eSRT in terms of cancer control. These men could be initially observed to reduce the risk of overtreatment and treatment-related side effects. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1212 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Antony Pellegrino More articles by this author Francesco Barletta More articles by this author Giorgio Gandaglia More articles by this author Simone Scuderi More articles by this author Pietro Scilipoti More articles by this author Mattia Longoni More articles by this author Armando Stabile More articles by this author Donato Cannoletta More articles by this author Leonardo Quarta More articles by this author Elio Mazzone More articles by this author Alfonso Santangelo More articles by this author Paolo Zaurito More articles by this author Alessandro Viti More articles by this author Riccardo Leni More articles by this author Giuseppe Ottone Cirulli More articles by this author Vito Cucchiara More articles by this author Daniele Robesti More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement PDF downloadLoading ...