Role of adjuvant radiotherapy following radical prostatectomy for microscopic residual disease

Radical prostatectomy and lymphadenectomy remain common therapy for stages A or B prostatic cancer. If surgical margins are positive, adjunctive radiotherapy is sometimes given. There is no clear evidence that such therapy alters the natural history of the disease. In an attempt to answer this question, we reviewed all 40 radical prostatectomy specimens seen at New York University Medical Center and Bellevue Hospital from 1977 to 1984. Twelve cases with microscopic disease at the surgical margins were found. Six of these patients received postoperative radiation and 6 observation only. In theory, microscopic residual disease following prostatectomy confers a high risk of local recurrence. Our retrospective study did not confirm this and questions the beneficial role of postoperative radiotherapy in such patients.