ESTRO 2024 - Abstract Book

S2638

Clinical - Urology

ESTRO 2024

Jackson WC, Desai NB, Abugharib AE, Tumati V, Dess RT, Lee JY, Zhao SG, Soliman M, Folkert M, Laine A, Hannan R, Zumsteg ZS, Sandler H, Hamstra DA, Montgomery JS, Miller DC, Kozminski MA, Hollenbeck BK, Hearn JW, Palapattu G, Tomlins SA, Mehra R, Morgan TM, Feng FY, Spratt DE. Anatomical patterns of recurrence following biochemical relapse after post-prostatectomy salvage radiation therapy: a multi-institutional study. BJU Int. 2017 Sep;120(3):351 357.

3217

Digital Poster

Upgrading or upstaging after prostatectomy: should the diagnosis of prostate cancer be changed?

María Cerrolaza Pascual 1 , Agustina Mendez 1 , Cristina Garcia 1 , Victoria Navarro 1 , Alberto Lanuza 1 , Claudia Colom 1 , Ana Galan 1 , Javier Diez 2 , Martin Tejedor 1 1 University Hospital Miguel Servet, Radiation Oncology, ZARAGOZA, Spain. 2 University Hospital Miguel Servet, Physics, ZARAGOZA, Spain

Purpose/Objective:

in current clinical practice, detection of prostate cancer consists of a systematic prostate biopsy in patients with elevated PSA-levels or suspicion at digital rectal examination. Gleason score or ISUP and clinical stage are critical risk factors in the classification of prostate cancer. There are series reported that concordance rate between biopsy and specimen was 58.9%-63% while overall upgrading was found in 25-30%. Pathological upstaging to more aggressive diseases was also reported to affect 7-17% patients. Upgrading and upstaging were significantly associated with decrease oncological control. Our aim is to analyze the rate of patients who are candidates for prostatic bed radiotherapy due to biochemical recurrence and who present upgrading or upstaging after prostatectomy with respect to the initial biopsy.

Material/Methods:

we collected patients who were candidates for prostate bed radiotherapy after prostatectomy in our center between 2015-2023. Those with complete anatomopathological data were selected. A retrospective uni and multivariate analysis of clinical and pathological characteristics of both biopsy and prostatectomy was performed. A value of p<0.5 was considered statistically significant.

Results:

156 patients with a mean age of 63.24 years and a mean PSA of 12.81 ng/ml underwent radical prostatectomy following biopsy confirming prostate cancer.

At biopsy 54 patients (34.6%) had ISUP 1, 46 (29.5%) presented ISUP 2, 23had ISUP 3 (14.7%) and 4 (14.7%) and 10 patients (6.4%) had ISUP 5. After radical prostatectomy 26 patients (16.7%) had ISUP 1, 52 patients (33.3%) ISUP 2, 34 (21.8%) ISUP 3, 15 (9.6%) ISUP 4 and 29 patients (18.6%) ISUP 5. Overall 40.5% of patients matched the biopsy