Re: identification of patients with prostate cancer who benefit from immediate postoperative radiotherapy: EORTC 22911.
rct · Level II
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Abstract
In EORTC22911, 1005 patients with pT3 prostate cancer following radical prostatectomy were randomized to observation or immediate postoperative adjuvant radiotherapy [1]. Van der Kwast performed a pathologic analysis of EORTC22911 using the radical prostatectomy specimens from 552 study patients. Patients with negative surgical margins had no benefit from postoperative radiotherapy. However, with positive margins, the hazard ratio for prostate-specific antigen (PSA) relapse was 0.38 for those receiving radiation compared with those who did not. Adjuvant radiation would prevent biochemical relapse by year 5 in 291 of every 1000 patients with positive margins compared with 88 of 1000 patients with negative margins.