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Edouard J. Trabulsi, MD, FACS, professor, co-director, Multidisciplinary Genitourinary Oncology Center, Prostate Diagnostic Center, vice chair of research, director, Division of Urologic Oncology, Department of Urology, Sidney Kimmel Cancer Center, discusses postoperative radiation in patients with prostate cancer.
Edouard J. Trabulsi, MD, FACS, professor, co-director, Multidisciplinary Genitourinary Oncology Center, Prostate Diagnostic Center, vice chair of research, director, Division of Urologic Oncology, Department of Urology, Sidney Kimmel Cancer Center, discusses postoperative radiation in patients with prostate cancer.
Patients with prostate cancer who have positive margins are at a very high risk of recurrence, Trabulsi says. There have been several large, randomized trials in the United States and Europe of postoperative radiotherapy looking at patients who fit this category. The US trial showed decreased rates of metastasis and improved survival in patients who received postoperative radiotherapy, says Trabulsi.
A population of men are cured with surgery alone, so additional therapy for them may not be necessary. Additionally, urologists are concerned about the postsurgical side effects and overtreatment with the postoperative radiation. Trabulsi says that prostate-specific antigen could potentially differentiate between who needs postoperative radiation and who does not.
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