Individualization of Adjuvant Therapy After Radical Prostatectomy for Clinically Localized Prostate Cancer: Current Status and Future Directions

Darrion L Mitchell; Chad R Tracy; John M Buatti; Mark C Smith; Anthony N Snow; Michael D Henry; Daniel A Vaena; Hamed H Tewfik; John M Watkins

doi:10.1016/j.clgc.2015.07.022

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Individualization of Adjuvant Therapy After Radical Prostatectomy for Clinically Localized Prostate Cancer: Current Status and Future Directions

Journal article

Peer reviewed

Individualization of Adjuvant Therapy After Radical Prostatectomy for Clinically Localized Prostate Cancer: Current Status and Future Directions

Darrion L Mitchell, Chad R Tracy, John M Buatti, Mark C Smith, Anthony N Snow, Michael D Henry, Daniel A Vaena, Hamed H Tewfik and John M Watkins

Clinical genitourinary cancer, Vol.14(1), pp.12-21

02/2016

DOI: 10.1016/j.clgc.2015.07.022

PMID: 26341039

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Abstract

Radiation therapy indications in the postprostatectomy setting are evolving. Several retrospective series have identified a number of “high-risk” pathologic features associated with an elevated risk of disease recurrence after radical prostatectomy. More recently, several randomized phase III trials demonstrated superior biochemical relapse-free survival for adjuvant radiation therapy after prostatectomy for patients with these high-risk pathologic features, including positive margin status, extraprostatic extension, and/or seminal vesicle invasion. These series further suggested improvement in distant metastasis control and overall survival after 15 years. However, not all patients with high-risk features experience disease recurrence after surgery alone, and some subsets of patients experience suboptimal disease control and survival despite immediate postoperative radiotherapy. Furthermore, some patients without high-risk features will develop recurrence. The present review discusses the current data and potential future directions to improve individualization of therapy after prostatectomy.

Prostate neoplasms

Radiotherapy

Margin involvement

Adjuvant therapy

Surgical pathology

Details

Title: Subtitle: Individualization of Adjuvant Therapy After Radical Prostatectomy for Clinically Localized Prostate Cancer: Current Status and Future Directions
Creators: Darrion L Mitchell - Department of Radiation Oncology, University of Iowa Carver School of Medicine, Iowa City, IA
Chad R Tracy - Department of Urology, University of Iowa Carver School of Medicine, Iowa City, IA
John M Buatti - Department of Radiation Oncology, University of Iowa Carver School of Medicine, Iowa City, IA
Mark C Smith - Department of Radiation Oncology, University of Iowa Carver School of Medicine, Iowa City, IA
Anthony N Snow - Department of Pathology, University of Iowa Carver School of Medicine, Iowa City, IA
Michael D Henry - Department of Molecular Physiology and Biophysics and Holden Comprehensive Cancer Center, University of Iowa Carver School of Medicine, Iowa City, IA
Daniel A Vaena - Department of Hematology and Oncology, University of Iowa Carver School of Medicine, Iowa City, IA
Hamed H Tewfik - Iowa City Cancer Treatment Center, Iowa City, IA
John M Watkins - Department of Radiation Oncology, University of Iowa Carver School of Medicine, Iowa City, IA
Resource Type: Journal article
Publication Details: Clinical genitourinary cancer, Vol.14(1), pp.12-21
Publisher: Elsevier Inc
DOI: 10.1016/j.clgc.2015.07.022
PMID: 26341039
ISSN: 1558-7673
eISSN: 1938-0682
Language: English
Date published: 02/2016
Academic Unit: Radiology; Molecular Physiology and Biophysics; Pathology; Radiation Oncology; Urology; Neurosurgery; Otolaryngology; Internal Medicine
Record Identifier: 9984040228902771

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