SURGICALLY STAGED PATIENTS WITH PROSTATIC-CARCINOMA TREATED WITH DEFINITIVE RADIOTHERAPY - 15-YEAR RESULTS

Objective. To assess the long-term outcome of patients with lymphadene ctomy-staged prostate cancer treated with external beam radiotherapy. Methods. A retrospective analysis was performed on all patients with p rostate cancer who underwent staging pelvic lymphadenectomy before tre atment with definitive radiotherapy from 1 970 to February 1978. This included 71 patients who were evaluated for a minimum of fifteen years . No patients were lost to follow-up. Thirty-five patients were node n egative and 36 were node positive. Results. Fifteen-year actuarial ove rall survival, cause-specific survival, and local control for the 20 p atients with clinically organ-confined disease (T1b-T2 NOMO) was 40 pe rcent, 75 percent, and 92 percent, respectively. The results for the 1 5 T3 NOMO patients were 1 5 percent, 22 percent, and 60 percent. Patie nts with positive nodes did much worse, with rates of 5 percent, 6 per cent, and 45 percent. Thirty-four patients received hormonal therapy a t the time of first failure. No patient who was clinically free of dis ease at fifteen years had an elevated level of prostate-specific antig en (PSA). Conclusions. Our data suggest excellent results in a cohort of patients (T1b-T2 NOMO) treated with primary radiotherapy who would be considered candidates for radical prostatectomy. Outcome is signifi cantly worse in patients with T3 lesions and node-positive disease.