[Immediate or delayed postoperative radiotherapy in prostate cancer]

Area of Science:

• Urology
• Oncology
• Radiation Oncology

Background:

• Radical prostatectomy is a primary treatment for prostate cancer.
• Relapse after surgery is a significant concern for patients.
• Predictors of relapse include clinical stage, Gleason score, and surgical margins.

Purpose of the Study:

• To evaluate the effectiveness of adjuvant radiotherapy in high-risk prostate cancer patients post-radical prostatectomy.
• To assess the cure rate of radiotherapy for biochemical relapses (rising PSA).
• To determine the role of concomitant hormonotherapy in managing relapsed prostate cancer.

Main Methods:

• Analysis of relapse rates based on clinical stage, Gleason score, and surgical margins.
• Evaluation of outcomes for adjuvant radiotherapy in high-risk groups.
• Assessment of radiotherapy efficacy for biochemical recurrence after prompt initiation.
• Review of ongoing trials (EORTC, AFU/GETUG) for definitive data.

Main Results:

• Relapse after radical prostatectomy is strongly correlated with clinical stage, Gleason score, and surgical margins.
• Adjuvant radiotherapy is suggested as the optimal treatment for high-risk patients, pending EORTC results.
• Radiotherapy can achieve a 50% cure rate for biochemical relapses if initiated promptly after PSA rise.
• The benefit of concomitant hormonotherapy is under investigation.

Conclusions:

• Clinical factors significantly predict relapse after radical prostatectomy.
• Prompt radiotherapy offers a potential cure for biochemical relapses.
• Further results from EORTC and AFU/GETUG studies are crucial for definitive treatment guidelines.