THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY endorsed a guideline published by the American Urological Association and the American Society for Radiation Oncology on the use of adjuvant and salvage radiotherapy after prostatectomy. The endorsement was published in the Journal of Clinical Oncology.
The AUA/ASTRO guideline recommends that physicians discuss adjuvant radiotherapy with patients who have adverse pathologic findings at prostatectomy (i.e., seminal vesicle invasion, extensive positive surgical margins) and salvage radiotherapy with patients with detectable postoperative prostate-specific antigen or local recurrence after prostatectomy.
Patients should be informed that, while adjuvant radiotherapy reduces the risk of recurrence and disease progression, its impact on preventing metastases and extending survival is less clear, the guideline states. The recommendations were published August 2013 in the Journal of Urology.
The society added one qualifying statement that not all men who are candidates for adjuvant or salvage radiotherapy have the same risk of recurrence or disease progression, and thus, not all men will derive the same benefit from adjuvant radiotherapy. Those at the highest risk for recurrence after radical prostatectomy (including men with seminal vesicle invasion, Gleason score 8 to 10, extensive positive margins, and detectable postoperative PSA) are likely to derive the greatest benefit.
