According to an article recently published in the Journal of Clinical Oncology, men with early prostate cancer who have negative margins following surgery (no signs of cancer on the margins of the tissue that was surgically removed) may not benefit from immediate radiation following surgery.
The prostate is a gland of the male reproductive system. It produces some of the fluid that transports sperm during ejaculation. After skin cancer prostate cancer is the most common form of cancer diagnosed in men. The outlook for men diagnosed with prostate cancer is good: overall survival rates for all stages of prostate cancer have improved dramatically over the past 20 years.
Treatment for prostate cancer is largely dependent upon the extent of spread of cancer. Early prostate cancer refers to cancer that has not spread from its site of origin to distant sites in the body. Current treatment options for prostate cancer include watchful waiting, surgery, chemotherapy, radiation, or androgen deprivation therapy (ADT; also referred to as hormonal therapy). Often, patients receive radiation following surgery to kill any cancer cells that may remain. However, because radiation therapy is associated with side effects, researchers are evaluating ways to reduce unnecessary therapy while maintaining optimal outcomes.
Researchers affiliated with the European Organisation for Research and Treatment of Cancer (EORTC) recently conducted a clinical trial, referred to as the EORTC 22911 trial, to evaluate the effects of radiation therapy following surgery for patients with early prostate cancer. This trial included 1,005 patients who had positive surgical margins (cancer cells were found on the margins of the tissue that was surgically removed) and/or had cancer cells extending through the capsule that surrounds the prostate. All patients underwent surgery; one group of patients was treated with radiation therapy following surgery, and the other group of patients had no further treatment.
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- Margin status (negative or positive margins) was the strongest predictor of long-term cancer-free survival in patients who received radiation immediately following surgery.
- By year five radiation immediately following surgery reduced disease progression or recurrence by 62% among patients with positive margins compared with only 12% among patients with negative margins.
The researchers concluded: “Our results suggest that immediate postoperative radiotherapy might not be recommended for prostate cancer patients with negative surgical margins. These findings require validation [with further study].” Men diagnosed with prostate cancer may wish to speak with their physician regarding their individual risks and benefits for all treatment options.
Reference: Van der Kwast T, Bolla M, Van Poppel H, et al. Identification of patients with prostate cancer who benefit from immediate postoperative radiotherapy: EORTC 22911. Journal of Clinical Oncology. 2007;25: 4178-4186.