Identification of Patients With Prostate Cancer Who Benefit From Immediate Postoperative Radiotherapy: EORTC 22911
The randomized controlled European Organisation for Research and Treatment of Cancer (EORTC) trial 22911 studied the effect of radiotherapy after prostatectomy in patients with adverse risk factors. Review pathology data of specimens from participants in this trial were analyzed to identify which fa...
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| Veröffentlicht in: | Journal of clinical oncology 2007-09, Vol.25 (27), p.4178-4186 |
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| creator | VAN DER KWAST, Theodorus H BOLLA, Michel VAN POPPEL, Hein VAN CANGH, Paul VEKEMANS, Kris DA POZZO, Luigi BOSSET, Jean-Francois KURTH, Karl H SCHRÖDER, Fritz H COLLETTE, Laurence |
| description | The randomized controlled European Organisation for Research and Treatment of Cancer (EORTC) trial 22911 studied the effect of radiotherapy after prostatectomy in patients with adverse risk factors. Review pathology data of specimens from participants in this trial were analyzed to identify which factors predict increased benefit from adjuvant radiotherapy.
After prostatectomy, 1,005 patients with stage pT3 and/or positive surgical margins were randomly assigned to a wait-and-see (n = 503) and an adjuvant radiotherapy (60 Gy conventional irradiation) arm (n = 502). Pathologic review data were available for 552 patients from 11 participating centers. The interaction between the review pathology characteristics and treatment benefit was assessed by log-rank test for heterogeneity (P < .05).
Margin status assessed by review pathology was the strongest predictor of prolonged biochemical disease-free survival with immediate postoperative radiotherapy (heterogeneity, P < .01): by year 5, immediate postoperative irradiation could prevent 291 events/1,000 patients with positive margins versus 88 events/1,000 patients with negative margins. The hazard ratio for immediate irradiation was 0.38 (95% CI, 0.26 to 0.54) and 0.88 (95% CI, 0.53 to 1.46) in the groups with positive and negative margins, respectively. We could not identify a significant impact of the positive margin localization.
Provided careful pathology of the prostatectomy is performed, our results suggest that immediate postoperative radiotherapy might not be recommended for prostate cancer patients with negative surgical margins. These findings require validation on an independent data set. |
| doi_str_mv | 10.1200/JCO.2006.10.4067 |
| format | Article |
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After prostatectomy, 1,005 patients with stage pT3 and/or positive surgical margins were randomly assigned to a wait-and-see (n = 503) and an adjuvant radiotherapy (60 Gy conventional irradiation) arm (n = 502). Pathologic review data were available for 552 patients from 11 participating centers. The interaction between the review pathology characteristics and treatment benefit was assessed by log-rank test for heterogeneity (P < .05).
Margin status assessed by review pathology was the strongest predictor of prolonged biochemical disease-free survival with immediate postoperative radiotherapy (heterogeneity, P < .01): by year 5, immediate postoperative irradiation could prevent 291 events/1,000 patients with positive margins versus 88 events/1,000 patients with negative margins. The hazard ratio for immediate irradiation was 0.38 (95% CI, 0.26 to 0.54) and 0.88 (95% CI, 0.53 to 1.46) in the groups with positive and negative margins, respectively. We could not identify a significant impact of the positive margin localization.
Provided careful pathology of the prostatectomy is performed, our results suggest that immediate postoperative radiotherapy might not be recommended for prostate cancer patients with negative surgical margins. These findings require validation on an independent data set.</description><identifier>ISSN: 0732-183X</identifier><identifier>EISSN: 1527-7755</identifier><identifier>DOI: 10.1200/JCO.2006.10.4067</identifier><identifier>PMID: 17878474</identifier><language>eng</language><publisher>Baltimore, MD: American Society of Clinical Oncology</publisher><subject>Aged ; Biological and medical sciences ; Cancer ; Combined Modality Therapy ; Disease Progression ; Disease-Free Survival ; Europe ; Genital system. Mammary gland ; Humans ; Life Sciences ; Male ; Medical sciences ; Middle Aged ; Proportional Hazards Models ; Prostate-Specific Antigen ; Prostate-Specific Antigen - metabolism ; Prostatectomy ; Prostatic Neoplasms ; Prostatic Neoplasms - radiotherapy ; Prostatic Neoplasms - surgery ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Risk Factors ; Treatment Outcome ; Tumors</subject><ispartof>Journal of clinical oncology, 2007-09, Vol.25 (27), p.4178-4186</ispartof><rights>2007 INIST-CNRS</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c435t-bca6b92039d350567c6295de75d76577a57de2a4405a4207ad417bf92fb6dedd3</citedby><cites>FETCH-LOGICAL-c435t-bca6b92039d350567c6295de75d76577a57de2a4405a4207ad417bf92fb6dedd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,3716,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19132953$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17878474$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-00492622$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>VAN DER KWAST, Theodorus H</creatorcontrib><creatorcontrib>BOLLA, Michel</creatorcontrib><creatorcontrib>VAN POPPEL, Hein</creatorcontrib><creatorcontrib>VAN CANGH, Paul</creatorcontrib><creatorcontrib>VEKEMANS, Kris</creatorcontrib><creatorcontrib>DA POZZO, Luigi</creatorcontrib><creatorcontrib>BOSSET, Jean-Francois</creatorcontrib><creatorcontrib>KURTH, Karl H</creatorcontrib><creatorcontrib>SCHRÖDER, Fritz H</creatorcontrib><creatorcontrib>COLLETTE, Laurence</creatorcontrib><creatorcontrib>EORTC 22911</creatorcontrib><title>Identification of Patients With Prostate Cancer Who Benefit From Immediate Postoperative Radiotherapy: EORTC 22911</title><title>Journal of clinical oncology</title><addtitle>J Clin Oncol</addtitle><description>The randomized controlled European Organisation for Research and Treatment of Cancer (EORTC) trial 22911 studied the effect of radiotherapy after prostatectomy in patients with adverse risk factors. Review pathology data of specimens from participants in this trial were analyzed to identify which factors predict increased benefit from adjuvant radiotherapy.
After prostatectomy, 1,005 patients with stage pT3 and/or positive surgical margins were randomly assigned to a wait-and-see (n = 503) and an adjuvant radiotherapy (60 Gy conventional irradiation) arm (n = 502). Pathologic review data were available for 552 patients from 11 participating centers. The interaction between the review pathology characteristics and treatment benefit was assessed by log-rank test for heterogeneity (P < .05).
Margin status assessed by review pathology was the strongest predictor of prolonged biochemical disease-free survival with immediate postoperative radiotherapy (heterogeneity, P < .01): by year 5, immediate postoperative irradiation could prevent 291 events/1,000 patients with positive margins versus 88 events/1,000 patients with negative margins. The hazard ratio for immediate irradiation was 0.38 (95% CI, 0.26 to 0.54) and 0.88 (95% CI, 0.53 to 1.46) in the groups with positive and negative margins, respectively. We could not identify a significant impact of the positive margin localization.
Provided careful pathology of the prostatectomy is performed, our results suggest that immediate postoperative radiotherapy might not be recommended for prostate cancer patients with negative surgical margins. These findings require validation on an independent data set.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cancer</subject><subject>Combined Modality Therapy</subject><subject>Disease Progression</subject><subject>Disease-Free Survival</subject><subject>Europe</subject><subject>Genital system. Mammary gland</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Proportional Hazards Models</subject><subject>Prostate-Specific Antigen</subject><subject>Prostate-Specific Antigen - metabolism</subject><subject>Prostatectomy</subject><subject>Prostatic Neoplasms</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0732-183X</issn><issn>1527-7755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkc1v1DAUxC0Eokvhzgn5AohDFn876a1ELV200q6qonKznNghrpJ4sb1F_e9xtBE9PXv0eyO9GQDeY7TGBKGvP-rdOk-xzgJDQr4AK8yJLKTk_CVYIUlJgUv66wy8ifEBIcxKyl-DMyxLWTLJViBsjJ2S61yrk_MT9B3c51fWIrx3qYf74GPSycJaT60N8L738JudbOcSvA5-hJtxtMbNxD6T_mBD3n-08FYb51Ofv4enC3i1u72rISEVxm_Bq04P0b5b5jn4eX11V98U2933TX25LVpGeSqaVoumIohWhnLEhWwFqbixkhspuJSaS2OJZgxxzQiS2jAsm64iXSOMNYaegy8n314P6hDcqMOT8tqpm8utmjWEWEUEIY84s59O7CH4P0cbkxpdbO0w6Mn6Y1SiJGUpRZlBdALbnEsMtvvvjJGaO1G5EzV3MgtzJ3nlw-J9bHJUzwtLCRn4uAA6tnroQk7axWeuwjRfTjP3eTnI_e7_umBVHPUwZFuiHlpPuCJS5RBK-g9qxqAk</recordid><startdate>20070920</startdate><enddate>20070920</enddate><creator>VAN DER KWAST, Theodorus H</creator><creator>BOLLA, Michel</creator><creator>VAN POPPEL, Hein</creator><creator>VAN CANGH, Paul</creator><creator>VEKEMANS, Kris</creator><creator>DA POZZO, Luigi</creator><creator>BOSSET, Jean-Francois</creator><creator>KURTH, Karl H</creator><creator>SCHRÖDER, Fritz H</creator><creator>COLLETTE, Laurence</creator><general>American Society of Clinical Oncology</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope></search><sort><creationdate>20070920</creationdate><title>Identification of Patients With Prostate Cancer Who Benefit From Immediate Postoperative Radiotherapy: EORTC 22911</title><author>VAN DER KWAST, Theodorus H ; BOLLA, Michel ; VAN POPPEL, Hein ; VAN CANGH, Paul ; VEKEMANS, Kris ; DA POZZO, Luigi ; BOSSET, Jean-Francois ; KURTH, Karl H ; SCHRÖDER, Fritz H ; COLLETTE, Laurence</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c435t-bca6b92039d350567c6295de75d76577a57de2a4405a4207ad417bf92fb6dedd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cancer</topic><topic>Combined Modality Therapy</topic><topic>Disease Progression</topic><topic>Disease-Free Survival</topic><topic>Europe</topic><topic>Genital system. Mammary gland</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Proportional Hazards Models</topic><topic>Prostate-Specific Antigen</topic><topic>Prostate-Specific Antigen - metabolism</topic><topic>Prostatectomy</topic><topic>Prostatic Neoplasms</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>Prostatic Neoplasms - surgery</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>VAN DER KWAST, Theodorus H</creatorcontrib><creatorcontrib>BOLLA, Michel</creatorcontrib><creatorcontrib>VAN POPPEL, Hein</creatorcontrib><creatorcontrib>VAN CANGH, Paul</creatorcontrib><creatorcontrib>VEKEMANS, Kris</creatorcontrib><creatorcontrib>DA POZZO, Luigi</creatorcontrib><creatorcontrib>BOSSET, Jean-Francois</creatorcontrib><creatorcontrib>KURTH, Karl H</creatorcontrib><creatorcontrib>SCHRÖDER, Fritz H</creatorcontrib><creatorcontrib>COLLETTE, Laurence</creatorcontrib><creatorcontrib>EORTC 22911</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>VAN DER KWAST, Theodorus H</au><au>BOLLA, Michel</au><au>VAN POPPEL, Hein</au><au>VAN CANGH, Paul</au><au>VEKEMANS, Kris</au><au>DA POZZO, Luigi</au><au>BOSSET, Jean-Francois</au><au>KURTH, Karl H</au><au>SCHRÖDER, Fritz H</au><au>COLLETTE, Laurence</au><aucorp>EORTC 22911</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Identification of Patients With Prostate Cancer Who Benefit From Immediate Postoperative Radiotherapy: EORTC 22911</atitle><jtitle>Journal of clinical oncology</jtitle><addtitle>J Clin Oncol</addtitle><date>2007-09-20</date><risdate>2007</risdate><volume>25</volume><issue>27</issue><spage>4178</spage><epage>4186</epage><pages>4178-4186</pages><issn>0732-183X</issn><eissn>1527-7755</eissn><abstract>The randomized controlled European Organisation for Research and Treatment of Cancer (EORTC) trial 22911 studied the effect of radiotherapy after prostatectomy in patients with adverse risk factors. Review pathology data of specimens from participants in this trial were analyzed to identify which factors predict increased benefit from adjuvant radiotherapy.
After prostatectomy, 1,005 patients with stage pT3 and/or positive surgical margins were randomly assigned to a wait-and-see (n = 503) and an adjuvant radiotherapy (60 Gy conventional irradiation) arm (n = 502). Pathologic review data were available for 552 patients from 11 participating centers. The interaction between the review pathology characteristics and treatment benefit was assessed by log-rank test for heterogeneity (P < .05).
Margin status assessed by review pathology was the strongest predictor of prolonged biochemical disease-free survival with immediate postoperative radiotherapy (heterogeneity, P < .01): by year 5, immediate postoperative irradiation could prevent 291 events/1,000 patients with positive margins versus 88 events/1,000 patients with negative margins. The hazard ratio for immediate irradiation was 0.38 (95% CI, 0.26 to 0.54) and 0.88 (95% CI, 0.53 to 1.46) in the groups with positive and negative margins, respectively. We could not identify a significant impact of the positive margin localization.
Provided careful pathology of the prostatectomy is performed, our results suggest that immediate postoperative radiotherapy might not be recommended for prostate cancer patients with negative surgical margins. These findings require validation on an independent data set.</abstract><cop>Baltimore, MD</cop><pub>American Society of Clinical Oncology</pub><pmid>17878474</pmid><doi>10.1200/JCO.2006.10.4067</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Society of Clinical Oncology Online Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Biological and medical sciences Cancer Combined Modality Therapy Disease Progression Disease-Free Survival Europe Genital system. Mammary gland Humans Life Sciences Male Medical sciences Middle Aged Proportional Hazards Models Prostate-Specific Antigen Prostate-Specific Antigen - metabolism Prostatectomy Prostatic Neoplasms Prostatic Neoplasms - radiotherapy Prostatic Neoplasms - surgery Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Risk Factors Treatment Outcome Tumors |
| title | Identification of Patients With Prostate Cancer Who Benefit From Immediate Postoperative Radiotherapy: EORTC 22911 |
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