Buscar en
Actas Urológicas Españolas (English Edition)
Toda la web
Inicio Actas Urológicas Españolas (English Edition) Oncological control in high-risk prostate cancer after radical prostatectomy and...
Journal Information
Vol. 43. Issue 4.
Pages 190-197 (May 2019)
Download PDF
More article options
Vol. 43. Issue 4.
Pages 190-197 (May 2019)
Original article
DOI: 10.1016/j.acuroe.2019.03.006
Oncological control in high-risk prostate cancer after radical prostatectomy and salvage radiotherapy compared to radiotherapy plus primary hormone therapy
Control oncológico en cáncer de próstata de alto riesgo tras prostatectomía radical y radioterapia de rescate en comparación con radioterapia más hormonoterapia primaria
J. Caño-Velasco
Corresponding author

Corresponding author.
, F. Herranz-Amo, G. Barbas-Bernardos, L. Polanco-Pujol, F. Verdú-Tartajo, E. Lledó-García, C. Hernández-Fernández
Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
This item has received
Article information
Full Text
Download PDF
Figures (1)
Tables (5)
Table 1. Comparison of clinical variables according to administered treatment.
Table 2. Pathologic variables after radical prostatectomy.
Table 3. Estimation of the RFS according to administered treatment.
Table 4. Univariate and multivariate analysis of the variables that may influence relapse-free survival.
Table 5. Univariate and multivariate analysis of the variables that may influence relapse-free survival rates after salvage thereapy.
Show moreShow less

In patients with high-risk localized prostate cancer (HRPCa), multimodal treatment plays a fundamental role.


To compare relapse-free survival (RFS) in patients with HRPCa, treated primarily with radiotherapy (RT)+hormone therapy (HT) versus radical prostatectomy (RP) and salvage RT (sRT)±HT when biochemical recurrence (BCR) appears.

Material and methods

Retrospective analysis of 226 patients with HRPCa (1996–2008), treated primarily with RT+HT (n=137) or RP (n=89). The Kaplan–Meier method has been used to evaluate survival and the log-rank test has been used to evaluate the contrast between the different categories of the variables. Multivariate analysis has been performed using Cox regression to determine variables with an impact on RFS with statistical significance (p<0.05).


The median follow-up of the series was 111 (IQR 85–137.5) months. After RT+HT, 32 (23.4%) patients relapsed, and after RP 41 (46.1%) cases, (p=0.0001). When comparing the primary treatments, the RFS at 5 and 10 years was higher after RT+HT versus RP in monotherapy (p=0.001). The primary treatment with RT+HT reduced the risk of BCR when compared to the RP (HR=0.41, p=0.002). The estimation of the RFS at 5 and 10 years after RP+sRT±HT was 89.7 and 87.1%, while after primary RT+HT was 91.6 and 71.1%, respectively (p=0.01). The only factor that behaved as an independent predictor of RFS was the multimodal treatment with RP+sRT±HT when BCR showed up (HR=2.39, p=0.01).


In HRPCa, multimodal treatment with RP+sRT±HT if BCR, significantly improves RFS with respect to treatment with RT+HT.

High-risk prostate cancer
Recurrence-free survival
Hormone therapy
Salvage treatment

En pacientes con cáncer de próstata localizado de alto riesgo (CPAR) el tratamiento multimodal juega un papel fundamental.


Comparar la supervivencia libre de recidiva (SLR) en pacientes con CPAR tratados de forma primaria con radioterapia (RT)+hormonoterapia (HT) frente a prostatectomía radical (PR) rescatados con RT de rescate (RTR) con o sin HT tras recidiva bioquímica (RB).

Material y métodos

Análisis retrospectivo de 226 pacientes con CPAR (1996-2008), tratados de forma primaria con RT+HT (n=137) o PR (n=89). Utilizamos el método de Kaplan-Meier para evaluar la supervivencia y el test de log-rank para evaluar las diferencias entre las distintas categorías de las variables. Se realiza análisis multivariante mediante regresión de Cox para determinar variables con impacto en la SLR con significación estadística (p<0,05).


La mediana de seguimiento de la serie fue de 111 (RIC 85-137,5) meses. Tras RT+HT recidivaron 32 (23,4%) pacientes, y 41 (46,1%) tras PR (p=0,0001). Al comparar los tratamientos primarios, la SLR a los 5 y 10 años fue mayor tras RT+HT frente a PR en monoterapia (p=0,001). El tratamiento primario con RT+HT redujo a más de la mitad el riesgo de RB al compararse con la PR (HR=0,41, p=0,002). La estimación de la SLR a los 5 y 10 años después de PR+RTR±HT fue de 89,7 y 87,1%, mientras que tras RT+HT primaria fue de 91,6 y 71,1%, respectivamente (p=0,01). El único factor que se comportó como predictor independiente de SLR fue el tratamiento multimodal mediante PR+RTR±HT cuando se presentó la RB (HR=2,39, p=0,01).


En CPAR el tratamiento multimodal con PR+RTR±HT si RB mejora significativamente la SLR con respecto al tratamiento con RT+HT.

Palabras clave:
Cáncer de próstata de alto riesgo
Supervivencia libre de recidiva
Tratamiento de rescate


These are the options to access the full texts of the publication Actas Urológicas Españolas (English Edition)

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe to

Actas Urológicas Españolas (English Edition)

Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
NOTICE Undefined index: COMPRAR_ARTICULO (modulos/cuerpo/ayuda-acceso-item.php[65])

Comprar ahora
Article options
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.