New Guideline for Radiation After Prostatectomy Endorsed by ASCO

Guideline outlines use of adjuvant and salvage radiotherapy after surgery for prostate cancer.
Guideline outlines use of adjuvant and salvage radiotherapy after surgery for prostate cancer.

The American Society for Clinical Oncology (ASCO) has endorsed a recent guideline for adjuvant and salvage radiotherapy after prostatectomy. The endorsement was published in the Journal of Clinical Oncology.

Stephen J. Freedland, M.D., from Duke University in Durham, N.C., and colleagues reviewed the American Urological Association/American Society for Radiation Oncology guideline on adjuvant and salvage radiotherapy after prostatectomy.

The ASCO panel determined that the recommendations in the guideline are clear, thorough, and based on the most recent and relevant evidence. ASCO endorsed the guideline with the addition of one qualifying statement that not all candidates for adjuvant or salvage radiotherapy have the same risk for recurrence or progression, and consequently the risk-benefit ratios differ.

Men with seminal vesicle invasion, Gleason score 8 to 10, extensive positive margins, and detectable postoperative prostate-specific antigen (PSA) are at the highest risk for recurrence after radical prostatectomy.

"Physicians should discuss adjuvant radiotherapy with patients with adverse pathologic findings at prostatectomy (i.e., seminal vesicle invasion, positive surgical margins, extraprostatic extension) and salvage radiotherapy with patients with PSA or local recurrence after prostatectomy," the authors write.

"The discussion of radiotherapy should include possible short- and long-term adverse effects and potential benefits."

Several authors disclosed financial ties to pharmaceutical and biomedical companies.

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