Radiotherapy for isolated serum prostate specific antigen elevation after prostatectomy for prostate cancer

Purpose: Elevated serum prostate specific antigen (PSA) may be the initial and only indication of disease recurrence after prostatectomy for prostate: cancer. External beam radiotherapy may be given in this setting in an atte mpt to eradicate the disease but therapeutic outcomes after this approach r equire further description. We describe the intermediate term outcome in a large group of patients treated with radiotherapy and identify pre-therapy factors associated with disease outcome. Materials and Methods: We retrospectively studied a cohort of 166 consecuti ve patients treated with radiotherapy between July 1987 and May 1996. The K aplan-Meier method was used to describe patient outcome for the overall stu dy group, and statistical associations of pre-therapy variables with outcom e were sought to identify predictive factors. Results: At a median followup of 52 months 46% (95% confidence interval 38 to 55) of patients were expected to be free of biochemical relapse 5 years after radiotherapy. Multivariate analysis identified pathological classific ation (seminal vesicle invasion), tumor grade and pre-radiotherapy serum PS A as independent factors associated with biochemical relapse. Although in I of 6 patients a chronic complication was attributed to radiotherapy, it wa s often mild and self-limited in nature. Conclusions: In our current series approximately half of the patients treat ed with radiotherapy for an isolated elevation of serum PSA after prostatec tomy were free of biochemical relapse at 5 years of followup. Radiotherapy may be given in this setting with modest long-term morbidity.