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Of the approximately 60,000 men who undergo radical prostatectomy in the U.S. each year, more than one third have positive surgical margins or tumor invasion into the seminal vesicles. These pathologic findings correlate with excess risk for systemic disease recurrence as defined by prostate-specific antigen (PSA) failure. However, debate has raged over the benefits of adjuvant radiotherapy (RT) versus salvage RT at PSA failure.
Results of a prior study showed that among 425 men with T3N0M0 prostate cancer, those who received adjuvant RT (60–64 Gy) within 18 weeks of surgery had nonsignificantly longer metastatic disease-free survival (P=0.06) and longer overall survival (OS; P=0.16) than those who underwent observation (median follow-up, 10…