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Postoperative Treatment and Survival in Locally Advanced Prostate Cancer: Real-World Outcomes.
Anne Holck Storås1, Kaitlyn M Tsuruda2, Tor Åge Myklebust2
1Cancer Registry of Norway, Norwegian Institute of Public Health, Norway; Oslo University Hospital, Department of Oncology, Oslo, Norway.
Clinical Genitourinary Cancer
|January 10, 2026
Summary
Men with locally advanced prostate cancer (laPCa) often need further treatment after radical prostatectomy (RP). Postoperative radiotherapy shows better survival outcomes than endocrine therapy for relapse management.
Area of Science:
- Oncology
- Urology
- Public Health
Background:
- Locally advanced prostate cancer (laPCa) requires careful postoperative management after radical prostatectomy (RP).
- Understanding real-world treatment patterns is crucial for improving shared decision-making in laPCa care.
Purpose of the Study:
- To evaluate postoperative treatment strategies and survival outcomes for men with laPCa post-RP.
- To inform shared decision-making by detailing real-world treatment patterns and survival data.
Main Methods:
- Analysis of 3022 laPCa patients undergoing RP (2008-21) from the Cancer Registry of Norway.
- Data linkage with Norwegian Prescription Database and Patient Registry for treatment and survival analysis.
- Competing risk framework used for cause-specific mortality estimation.
Main Results:
- Over 10 years post-RP, 34% received radiotherapy, 19% endocrine therapy, and 14% systemic therapy.
- Higher PSA, cT3b stage, and ISUP grade 4-5 predicted increased need for postoperative treatment.
- 10-year prostate cancer-specific mortality was 2% with radiotherapy vs. 31% with initial endocrine therapy.
Conclusions:
- laPCa patients treated with RP show favorable long-term survival, but over half need relapse-directed therapy within 10 years.
- Relapse risk is tied to baseline tumor characteristics, necessitating prolonged surveillance.
- Further research on long-term functional outcomes and quality of life after multimodal treatment is warranted.
