OUTCOME FOR SURGICALLY STAGED LOCALIZED PROSTATE-CANCER TREATED WITH EXTERNAL-BEAM RADIATION-THERAPY

Purpose: A retrospective analysis was performed on patients with surgi cally staged localized prostate cancer treated with external beam radi ation therapy for 10-year overall, cause specific and disease-free sur vivals based on lack of clinical recurrence and 2 separate prostate sp ecific antigen criteria for cure. Materials and Methods: We analyzed 1 45 patients who received external beam radiation therapy after a negat ive staging pelvic lymphadenectomy for prostate cancer. Followup data were available for 129 patients (90%). Disease was stage A in 29 patie nts (22.5%), stage B in 64 (49.6%), stage B2/C in 2 (17%) and stage C in 14 (10.9%). Average potential followup from date of diagnosis was 1 1.5 years (minimum 7.2). Of the patients 87 potentially can be followe d for longer than 10 years. Disease-free survival was based on a norma l digital rectal examination, lack of symptoms suspicious for metastas is and application of 2 separate prostate specific antigen criteria of 4 ng./ml. or less (group 1), or 1.5 ng./ml. or less (group 2), Surviv al was analyzed with the Kaplan-Meier actuarial method. Results: Actua rial overall survival at 10 and 15 years was 63.7 and 49.6, respective ly, and cause specific survival was 84.2 and 80%, respectively. Diseas e-free survival was 54.5 and 32.4%, respectively, for group 1, and 42. 3 and 9.6%, respectively, for group 2. Conclusions: The improved patie nt selection inherent in surgical staging before definitive external b eam radiation therapy provides for improved overall and cause specific survival over that of patients without surgical staging. Biochemical disease-free survival also appears to be improved.