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Pelvic lymph node recurrence in high-risk prostate cancer following prostate-only radiotherapy

Published online by Cambridge University Press:  17 December 2021

Sameed Hussain*
Affiliation:
Combined Military Hospital, Rawalpindi, Punjab, Pakistan
Muhammad Imran Wajid
Affiliation:
Combined Military Hospital, Rawalpindi, Punjab, Pakistan
Muhammad Omer
Affiliation:
Combined Military Hospital, Rawalpindi, Punjab, Pakistan
Muhammad Yousuf Khan
Affiliation:
Combined Military Hospital, Rawalpindi, Punjab, Pakistan
Talha Maqsood
Affiliation:
Combined Military Hospital, Rawalpindi, Punjab, Pakistan
Adnan Zeb
Affiliation:
Combined Military Hospital, Rawalpindi, Punjab, Pakistan
*
Author for correspondence: Sameed Hussain, Combined Military Hospital, Rawalpindi, Punjab, Pakistan. Email: drsameed@gmail.com

Abstract

Introduction:

High-risk prostate cancer is the most common presentation at our institute among patients with non-metastatic prostate cancer. Traditionally, pelvic lymph nodes were given a prophylactic dose of radiotherapy while the prostate was given a curative dose of radiation. This study aims to evaluate patterns of failure in patients who had prostate-only radiation at our centre.

Materials and Methods:

All high-risk prostate cancer patients who underwent radical radiotherapy to prostate only since 2014 were retrospectively analysed. Local T stage, baseline prostate-specific antigen (PSA) and Gleason score were recorded. Bone scan and staging CT scan data were collected. Various dose levels prescribed to prostate were analysed. The follow-up records of these patients were assessed. Patients who failed in pelvic lymph nodes were recorded separately. Overall survival and failure-free survival were calculated using Kaplan–Meier curve.

Results:

One-hundred five patients fulfilling the inclusion criteria were analysed. Only three patients developed recurrence in pelvic lymph node following prostate-only radiotherapy (PORT). Five year overall survival was 77% while failure-free survival was 64%. Forty patients had a PSA failure after a median follow-up of 62 months.

Conclusions:

Most high-risk prostate cancer patients who progress following hormone therapy and PORT have metastases outside pelvis. Till further conclusive evidence is available PORT can be considered as a safe option.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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