WHICH PATIENTS SHOULD RECEIVE RADIOTHERAPY IN POSTOPERATIVE DISEASE RECURRENCE?

After radical prostatectomy (RP), up to 60% of patients with high-risk prostate cancer (PC), such as high Gleason score, extracapsular prostatic extension (ECE), positive margins, seminal vesicle involvement (SVI), will develop biochemical relapse and they will require further local treatment. Radiotherapy (RT) to the prostate bed has been used as adjuvant (ART) or salvage (SRT). In patients with high-risk PC, radiotherapy immediately after RP or adjuvant radiotherapy may eradicate residual localized microscopic disease and improve biochemical, progression-free survival, and overall survival. Only a few observational studies have compared RP patients who have received only RT with patients who have received RT with some form of hormonal therapy. A few of them have reported improved progression-free survival with addition of hormonal therapy to SRT, but benefit in overall survival (OS) is not yet known.