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• W3021796376 abstract "You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) III (MP37)1 Apr 2020MP37-17 CHANGING PATTERNS AND PREDICTORS OF SALVAGE RADIATION THERAPY USE OVER TIME IN PATIENTS TREATED FOR POST-PROSTATECTOMY BIOCHEMICAL RECURRENCE: A TREND ANALYSIS OVER A 20-YEAR PERIOD FROM A MULTI-INSTITUTIONAL SERIES Elio Mazzone*, Nicola Fossati, Jeffrey Karnes, Stephen A. Boorjian, Giovanni Motterle, Alberto Bossi, Tamizhanban Kumar, Nadia Di Muzio, Cesare Cozzarini, Barbara Noris Chiorda, Giorgio Gandaglia, Giuseppe Rosiello, Marco Bandini, Detlef Bartkowiak, Shahrokh Shariat, Gregor Goldner, Pierre I Karakiewicz, Gaëtan Devos, Steven Joniau, Charlien Berghen, Gert De Meerleer, Hendrik Van Poppel, Francesco Montorsi, Thomas Wiegel, and Alberto Briganti Elio Mazzone*Elio Mazzone* More articles by this author , Nicola FossatiNicola Fossati More articles by this author , Jeffrey KarnesJeffrey Karnes More articles by this author , Stephen A. BoorjianStephen A. Boorjian More articles by this author , Giovanni MotterleGiovanni Motterle More articles by this author , Alberto BossiAlberto Bossi More articles by this author , Tamizhanban KumarTamizhanban Kumar More articles by this author , Nadia Di MuzioNadia Di Muzio More articles by this author , Cesare CozzariniCesare Cozzarini More articles by this author , Barbara Noris ChiordaBarbara Noris Chiorda More articles by this author , Giorgio GandagliaGiorgio Gandaglia More articles by this author , Giuseppe RosielloGiuseppe Rosiello More articles by this author , Marco BandiniMarco Bandini More articles by this author , Detlef BartkowiakDetlef Bartkowiak More articles by this author , Shahrokh ShariatShahrokh Shariat More articles by this author , Gregor GoldnerGregor Goldner More articles by this author , Pierre I KarakiewiczPierre I Karakiewicz More articles by this author , Gaëtan DevosGaëtan Devos More articles by this author , Steven JoniauSteven Joniau More articles by this author , Charlien BerghenCharlien Berghen More articles by this author , Gert De MeerleerGert De Meerleer More articles by this author , Hendrik Van PoppelHendrik Van Poppel More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Thomas WiegelThomas Wiegel More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000886.017AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A rapidly changing scenario in the management of patients with PSA rising after radical prostatectomy (RP) may have determined different patterns of salvage radiation therapy (SRT) use over the last two decades. We aimed to define patterns and predictors of SRT administration relative to timing of treatment, PSA level, and biochemical outcome after SRT. METHODS: We included 1455 patients who received post-RP local radiation to the prostatic and seminal vesicle bed at seven tertiary referral centres for PSA rise over the last two decades (1998-2018). Timing of SRT was categorized as early (PSA level ≤0.5 ng/ml; ESRT) or late (PSA level >0.5 ng/ml; LSRT). Cumulative incidence methods were used to asses 5-year biochemical recurrence (BCR) rates in patients with at least 5 years of follow-up (n=891). Lowess analysis graphically represented the year-by-year trends in SRT type, median PSA level at SRT, and 5-year BCR after SRT. Logistic regression models (LoRM) were used to identify predictors of LSRT use. Covariates consisted of age at SRT, year of SRT, concomitant hormonal therapy (HT), pT stage, Gleason grade, and lymph nodal status. RESULTS: Median age and PSA level at SRT were 67 years and 0.3 ng/ml, respectively. Overall, 462 (32%) received whole pelvis radiation therapy (WPRT). The use of WPRT increased significantly over time (OR: 1.08; p<0.0001). Overall, 474 (33%) patients were managed with LSRT and 512 (35%) received concomitant HT. During the study period, ESRT use increased over time (from 50% to 71%; p<0.001), with the highest rate recorded in 2017 (82%). Similarly, median PSA level at SRT decreased from 0.55 to 0.22 ng/ml (p<0.001). In patients with at least 5-year follow-up, we observed a considerable decrease in cumulative 5-year BCR rates from 40% to 17% (p<0.001) between 1998 and 2013. At LoRM, more recent year of surgery was associated with lower LSRT use (OR 0.93; p<0.001). Conversely, concomitant HT use (OR 1.81, p<0.001) and advanced age (OR 1.04, p<0.001) were both independent predictors of LSRT use. CONCLUSIONS: The rate of patients treated with ESRT and WPRT steadily increased during the last two decades. This trend seems to be associated with an encouraging decreasing rate of post-SRT 5-yr BCR that was also confirmed at multivariable analyses. This trend highlights current practice of SRT, and reinforces the evidence on the association between ESRT and patient outcomes. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e567-e567 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Elio Mazzone* More articles by this author Nicola Fossati More articles by this author Jeffrey Karnes More articles by this author Stephen A. Boorjian More articles by this author Giovanni Motterle More articles by this author Alberto Bossi More articles by this author Tamizhanban Kumar More articles by this author Nadia Di Muzio More articles by this author Cesare Cozzarini More articles by this author Barbara Noris Chiorda More articles by this author Giorgio Gandaglia More articles by this author Giuseppe Rosiello More articles by this author Marco Bandini More articles by this author Detlef Bartkowiak More articles by this author Shahrokh Shariat More articles by this author Gregor Goldner More articles by this author Pierre I Karakiewicz More articles by this author Gaëtan Devos More articles by this author Steven Joniau More articles by this author Charlien Berghen More articles by this author Gert De Meerleer More articles by this author Hendrik Van Poppel More articles by this author Francesco Montorsi More articles by this author Thomas Wiegel More articles by this author Alberto Briganti More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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