EVALUATION OF SERUM PROSTATE-SPECIFIC ANTIGEN LEVELS AFTER POSTOPERATIVE RADIATION-THERAPY FOR PATHOLOGICAL STAGE T3, NO PROSTATE-CANCER

Objective: To analyze freedom from progression of serum prostate-speci fic antigen (PSA) levels in patients who have received radiation thera py after radical prostatectomy for pathologic stage T3, NO prostate ca ncer, Design: We assessed the freedom from PSA progression after posto perative radiation therapy and its relationship to several potential p rognostic factors during a median follow-up of 43 months, Material and Methods: Thirty Mayo patients received postoperative radiation therap y for pathologic stage T3, NO prostate cancer between January 1988 and April 1993, Radiation therapy was initiated within 6 months after pro statectomy, Radiation doses ranged from 60 to 67 Gy, Results: ''Freedo m from PSA failure'' was defined as the actuarial risk of maintaining a serum PSA level at 0.3 ng/mL or less, The freedom from failure rate was 66% at 3 and 4 years, Prognostic factors significantly associated with an improved freedom from failure were a preradiation PSA level of 1.0 ng/mL or less and no seminal vesicle involvement, A trend toward an improved freedom from failure was noted in patients with low-grade (1 and 2) tumors in comparison with high-grade (3 and 3) tumors, Treat ment-related morbidity was minimal, Conclusion: Radiation therapy afte r radical prostatectomy for pathologic stage T3, NO prostate cancer se ems to provide an improved freedom from PSA failure in comparison with that noted in other series of similar patients treated with radical p rostatectomy only.