MP45-13 INTERMEDIATE AND LONG-TERM PREDICTORS OF SATISFACTION FOLLOWING OPEN RADICAL RETROPUBIC PROSTATECTOMY

INTRODUCTION AND OBJECTIVES: The Phoenix definition for PSA failure following RT is the accepted way of defining biochemical failure but its accuracy has never been examined with long-term followup. We sought to compare this definition to the ASTRO and AUA definitions in prostate cancer (PC) patients treated with definitive RT METHODS: 1669 men with T1-3 PC were treated with brachytherapy alone or in conjunction with hormone therapy (HT) or external beam radiation (EBRT) and followed a minimum of 5 years (mean 10, range 5-20). The median PSA was 6.9 ng/ml (mean 9.7, range 0.3-300). There were 1128 (67.5%) low (NCCN), 369 (22.1%) intermediate and 172 (10.4%) with high risk disease. HT was given to 898 (53.8%, median 6 months). 568 (34%) had supplemental EBRT. Radiation doses were converted to the biologic effective dose (a/b1⁄42) and analyzed as 3 groups: 200 Gy2 (n1⁄4778). PSA failure definitions were the AUA (increase PSA to above 0.2 ng/ml), ASTRO (3 consecutive increases above a nadir) and Phoenix (nadir followed by rise of 2 ng/ml). Survival estimates were determined by Kaplan Meier method with significant differences determined by log rank and Cox proportions hazard rates. RESULTS: The 5, 10 and 15 year bFFF, the 10 year bFFF by NCCN and dose group for the three failure definitions are shown in the table (p 0.2 compared 5.5% of the ASTRO patients. The last PSA for non-failures was >0.21 in 16.4%, 7% and 3.1% of the patients in the 3 dose groups, respectively (p 200 Gy2) these differences are negligible with all 3 definitions demonstrating a 10 year bFFF rate of 90%. Biochemical FFF should be estimated using the AUA PSA failure definition unless the highest doses are delivered.