Combination of adjuvant radiotherapy and androgen deprivation therapy after radical prostatectomy in high risk prostate cancer patients - results from retrospective analysis.

PURPOSE: We retrospectively evaluated the outcome in prostate cancer (PCa) patients receiving combination of adjuvant radiotherapy (ART) and androgen deprivation therapy (ADT) after radical prostatectomy (RP). METHODS: Between 2004 and 2012, 132 patients were referred for ART to the Department of Oncology, University Hospital, Split. Fifty-six consecutive patients with at least one proven or possible adverse prognostic factor such as pelvic lymph nodes invasion (LNI), lymphovascular invasion (LVI), high tumor grade and high preoperative prostatic specific antigen (PSA) level received combination of ART and ADT, while 76 patients received ART alone. The ADT consisted of a luteinizing hormone releasing hormone (LHRH) agonist or bicalutamide at a dose of 150 mg per day. The duration of ADT was left at the discretion of the treating physician and it lasted 6 to 36 months (median 24).The effect of combination of ART and ADT on biochemical relapse-free survival (bRFS), metastases-free survival (mFS), disease-specific survival (DSS) and overall survival (OS) was estimated using the Kaplan-Meier method. RESULTS: After a median follow-up time of 61 months (range 13.6-113), the 5- and 7-year bRFS were 90.5 and 77.2%, respectively. Distant relapse occurred in 5 patients, resulting in 5- and 7-year mFS of 95.9 and 81.7%, respectively. During follow-up, 7 patients died (2 PCa deaths), resulting in 5- and 7-year DSS and OS of 100% and 94.7% and 90.6 and 81.5%, respectively. CONCLUSIONS: This retrospective study shows high bRFS, mFS, DSS and OS rates with the combination of ART and ADT in high-risk PCa patients.