ALEXANDRIA, Va. — The American Society of Clinical Oncology (ASCO) today issued an endorsement of the American Urological Association (AUA)/American Society for Radiation Oncology (ASTRO) guideline on the use of adjuvant and salvage radiotherapy after prostatectomy, which was based on a systematic review of medical literature. The ASCO endorsement was published today in the Journal of Clinical Oncology.
The AUA/ASTRO guideline recommends that physicians discuss adjuvant radiotherapy with patients who have adverse pathologic findings at prostatectomy (i.e., seminal vesicle invasion, extensive positive surgical margins) and salvage radiotherapy with patients with detectable postoperative prostate-specific antigen (PSA) or local recurrence after prostatectomy. Patients should be informed that, while adjuvant radiotherapy reduces the risk of recurrence and disease progression, its impact on preventing metastases and extending survival is less clear.
An ASCO guideline endorsement panel determined that the guideline recommendations, published in August 2013 in the Journal of Urology, are clear, thorough, and based on the most relevant scientific evidence. The Society added one qualifying statement that not all men who are candidates for adjuvant or salvage radiotherapy have the same risk of recurrence or disease progression, and thus, not all men will derive the same benefit from adjuvant radiotherapy. Those at the highest risk for recurrence after radical prostatectomy (including men with seminal vesicle invasion, Gleason score 8 to 10, extensive positive margins, and detectable postoperative PSA) are likely to derive the greatest benefit.
A podcast for patients with guideline endorsement co-chair Howard Sandler, MD, MS, is available at www.cancer.net/blog. The guideline is available at http://www.asco.org/guidelines/genitourinary-cancer, along with supplementary materials.
ASCO encourages feedback on its guidelines from oncologists, practitioners and patients through the ASCO Guidelines Wiki at www.asco.org/guidelineswiki.
Founded in 1964, the American Society of Clinical Oncology (ASCO) is the world’s leading professional organization representing physicians who care for people with cancer. With more than 35,000 members, ASCO is committed to improving cancer care through scientific meetings, educational programs and peer-reviewed journals. ASCO is supported by its affiliate organization, the Conquer Cancer Foundation, which funds groundbreaking research and programs that make a tangible difference in the lives of people with cancer. For ASCO information and resources, visit asco.org. Patient-oriented cancer information is available at Cancer.Net.