Adjuvant irradiation after prostatectomy for carcinoma of the prostate with positive surgical margins

Background. Patients with adenocarcinoma of the prostate treated with prostatectomy who have tumor at the margins of the surgical specimen or tumor involvement of the seminal vesicles have a high risk of local recurrence and metastastic disease. It is unclear whether postoperative irradiation improves their outcome. Methods. This is a retrospective analysis of patients treated with prostatectomy for adenocarcinoma of the prostate who had surgical margins or seminal vesicles involved by tumor. Thirty-four patients received adjuvant postoperative irradiation (Group 11, and 43 patients did not receive irradiation (Group 2). Results. The tumor control rates in the prostatic bed for patients who had radical prostatectomy were 100% and 84% in Groups 1 and 2, respectively (P = 0.017). Actuarial 10-year disease-free survival from the date of prostatectomy was 46% and 55% for Groups 1 and 2, respectively. Conclusions. Adjuvant irradiation after prostatectomy in patients with positive surgical margins or seminal vesicle invasion increases prostatic bed local tumor control but does not affect survival. Postoperative irradiation is associated with acceptable morbidity. Cancer 1994; 73:384-7.