In an article by Brigantine et al, published in Eur Urol (2012), the authors look at whether adjuvant or salvage radiotherapy is best to achieve prostate cancer cure following radical prostatectomy. This matched case control study of 890 men showed no difference in treating pT3 disease immediately post radical prostatectomy (adjuvant), or treating a rising PSA above 0.2 but below 0.5 ng/ml (salvage). At 2 and 5 years post surgery PSA recurrence free rates were about 91% and 80% in both groups with no statistical difference. Salvage treating reduces the need to treat all high risk men and reduces the morbidity of unnecessary radiotherapy. This is probably the best published evidence addressing this question to date, but the results of a randomised trial is awaited.
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