Boston—Treatment with radiotherapy (RT) plus androgen deprivation therapy (ADT) may improve survival for select patients who are found to have pathologic node-positive (pN1) prostate cancer at radical prostatectomy.
It appears, however, that only a minority of men are receiving this multimodal therapy, researchers reported at the AUA annual meeting in Boston.
“Current guidelines offer little guidance for treatment of men with pN1 prostate cancer after RP. The findings of our study suggest that many of these men are being undertreated and that consideration should be given to offering RT alone or with ADT as it may prolong their survival. However, determining whether or not there is a real benefit for these interventions will depend on conducting a prospective, randomized clinical trial,” said Alaa Hamada, MD, a urologist at Case Western Reserve University and Louis Stokes VA Medical Center, Cleveland.
In order to determine treatment patterns of pN1 disease among men with prostate cancer and the effects of different regimens on patient outcomes, Dr. Hamada and colleagues analyzed data from the National Cancer Database for the years 2004 to 2013. Excluding patients who underwent lymph node biopsy or aspiration and those who underwent salvage prostatectomy, they identified 11,742 patients with pN1 disease after prostatectomy and pelvic lymph node dissection. Of those patients, 51% were subsequently managed with observation, 25% received ADT alone, 17% received ADT plus RT, and 7% received only RT.