Adjuvant radiotherapy of high risk prostate cancer – pro
There are now 3 randomized studies testing adjuvant RT vs. observation for men with pT3 prostate cancer or positive margins after radical prostatectomy, each with >9 years of follow-up. ASCO endorsed American Urologic SOciety’s Guidelines, as follows:
Physicians should discuss adjuvant radiotherapy with patients with adverse pathologic findings at prostatectomy (ie, seminal vesicle invasion, positive surgical margins, extraprostatic extension) and salvage radiotherapy with patients with PSA or local recurrence after prostatectomy. The discussion of radiotherapy should include possible short- and long-term adverse effects and potential benefits. The decision to administer radiotherapy should be made by the patient and multidisciplinary treatment team, keeping in mind that not all men are at equal risk of recurrence or clinically meaningful disease progression.
Adjuvant and Salvage Radiotherapy After Prostatectomy: American Society of Clinical Oncology Clinical Practice Guideline Endorsement Journal of Clinical Oncology 32, no. 34 (December 2014) 3892-3898.