PREDICTORS OF SURVIVAL FOR PROSTATE CARCINOMA PATIENTS TREATED WITH SALVAGE RADICAL PROSTATECTOMY AFTER RADIATION-THERAPY

BACKGROUND. Salvage radical prostatectomy is a treatment option for pa tients with recurrent cancer following radiation therapy. This study w as conducted to identify predictors of survival for patients treated w ith salvage radical prostatectomy. METHODS. The authors studied 86 pro state carcinoma patients who underwent salvage radical prostatectomy f or locally persistent or recurrent prostate carcinoma at Mayo Clinic b etween 1967 and 1996. The mean interval from radiation therapy to biop sy-proven recurrence was 3.7 years (range, 6 months to 17 years). Pati ent age at surgery ranged from 51 to 78 years (median, 66 years). The mean follow-up after surgery was 5.8 years (range, 1.0-15.2 years). Co x proportional hazards models were used to identify clinical and patho logic factors associated with distant metastasis free survival and can cer specific survival. RESULTS. Actuarial distant metastasis free surv ival, cancer specific survival, and overall survival were 83%, 91%, an d 85% at 5 years and 69%, 64%, and 54% at 10 years, respectively. In m ultivariate analysis, radical prostatectomy Gleason score and DNA ploi dy were independent predictors of distant metastasis free survival and cancer specific survival. CONCLUSIONS. Postirradiation Gleason score and DNA ploidy were highly predictive of the clinical outcomes of pati ents treated by salvage radical prostatectomy after radiation therapy. Cancer 1998;83:2164-71. (C) 1998 American Cancer Society.