Adjuvant versus early salvage radiation therapy after radical prostatectomy for pN1 prostate cancer

The optimal timing of postradical prostatectomy radiation therapy in men with pN1 prostate cancer is not clear. A retrospective study at the University Hospital of Hamburg-Eppendorf (Germany) compared adjuvant radiation therapy (aRT) with early salvage radiation therapy (sRT) for the endpoint all-cause mortality (ACM) in these men. aRT compared with early sRT was associated with a significantly lower ACM risk per unit increase in positive pelvic lymph nodes (aHR 0.92; p=0.03). A significant difference in the 7-year adjusted ACM estimates favoring aRT versus early sRT was observed in men with four or more positive lymph nodes (panel B) but not in men with one to three positive lymph nodes (panel A).