Selected studies assessing local treatment in (any cT) cN1 M0 prostate cancer patients
Additional information
17.12.2025
| Study | n | Design | Study period / follow-up | Treatment arms | Effect on survival |
|---|---|---|---|---|---|
| ADT = androgen deprivation therapy; CSS = cancer-specific survival; EBRT = external beam radiotherapy in standard fractionation; FFS = failure-free survival; HR = hazard ratio; mo = months; n = number of patients; OS = overall survival; RP = radical prostatectomy; RT = radiotherapy; wk = week; yr = year. | |||||
| Bryant, et al., 2018 «Bryant AK, Kader AK, McKay RR ym. Definitive Radiation Therapy and Survival in Clinically Node-Positive Prostate Cancer. Int J Radiat Oncol Biol Phys 2018;101:1188-1193 »1 | 648 | Retrospective (National Veterans Affairs) | 2000-2015 61 mo. | ADT ± EBRT | Significant benefit for combined treatment only if PSA levels less than the median (26 ng/mL) All-cause mortality HR: 0.50 CSS, HR: 0.38 |
| Sarkar, et al., 2019 «Sarkar RR, Bryant AK, Parsons JK ym. Association between Radical Prostatectomy and Survival in Men with Clinically Node-positive Prostate Cancer. Eur Urol Oncol 2019;2:584-588 »2 | 741 | Retrospective (National Veterans Affairs) | 2000-2015 51 mo. | ADT ± local treatment (surgery or RT) | Significant benefit for RP All-cause mortality HR 0.36 CSS, HR: 0.32 No statistical difference for RP vs. RT (p ≥ 0.1) All-cause mortality HR: 047 CSS, HR: 0.88 |
| Lin, et al., 2015 «Lin CC, Gray PJ, Jemal A ym. Androgen deprivation with or without radiation therapy for clinically node-positive prostate cancer. J Natl Cancer Inst 2015;107: »3 | 983 before propensity score matching | Retrospective (NCDB) | 2004-2006 48 mo. | ADT ± EBRT | Significant benefit for combined treatment 5-yr. OS: 73% vs. 52% HR: 0.5 |
| Tward, et al., 2013 «Tward JD, Kokeny KE, Shrieve DC. Radiation therapy for clinically node-positive prostate adenocarcinoma is correlated with improved overall and prostate cancer-specific survival. Pract Radiat Oncol 20»4 | 1,100 | Retrospective (SEER) | 1988-2006 64 mo. | EBRT (n = 397) vs. no EBRT (n=703) No information on ADT) | Significant benefit for EBRT 5-yr. CSS: 78% vs. 71% HR: 0.66 5-yr. OS: 68% vs. 56%, HR: 0.70 |
| Rusthoven,et al. 2014 «Rusthoven CG, Carlson JA, Waxweiler TV ym. The impact of definitive local therapy for lymph node-positive prostate cancer: a population-based study. Int J Radiat Oncol Biol Phys 2014;88:1064-73 »5 | 796 | Retrospective (SEER) | 1995-2005 61 mo. | EBRT vs. no EBRT (no information on ADT) | Significant benefit for EBRT 10-yr. OS: 45% vs. 29% HR: 0.58 |
| Chierigo, et al. 2022 «Chierigo F, Borghesi M, Würnschimmel C, ym. Survival after radical prostatectomy versus radiation therapy in clinical node-positive prostate cancer. Prostate 2022;82(6):740-750 »9 | 4,685 | Retrospective (SEER) | 2004-2016 | RP or RT (unknown ADT status) | Propensity score matching
5-yr OS: 84.6% (RP) vs. 75% (RT), HR 0.62, p < 0.001 5-yr CSS: 90.7% (RP) vs. 83% (RT), HR 0.62, p < 0.001 5-yr other cause mortality, 6.1% RP vs. 8.0% RT, HR 0.71, p = 0.04 |
| Seisen, et al., 2018 «Seisen T, Vetterlein MW, Karabon P ym. Efficacy of Local Treatment in Prostate Cancer Patients with Clinically Pelvic Lymph Node-positive Disease at Initial Diagnosis. Eur Urol 2018;73:452-461 »6 | 1,987 | Retrospective (NCDB) | 2003-2011 50 mo. | ADT ± local treatment (surgery or RT) | Significant benefit for combined treatment 5-yr. OS: 78.8% vs. 49.2% HR: 0.31 No difference between RP and RT |
| James, et al., 2016 «James ND, Spears MR, Clarke NW ym. Failure-Free Survival and Radiotherapy in Patients With Newly Diagnosed Nonmetastatic Prostate Cancer: Data From Patients in the Control Arm of the STAMPEDE Trial. J»7 | 177 | Unplanned subgroup analysis RCT | 2005-2014 17 mo. | ADT ± EBRT | Significant benefit for combined treatment 5-yr OS: 93% vs. 71% 2-yr FFS: 81% vs. 53% FFS, HR: 0.48 |
| Elumalai et al. «Elumalai T, Maitre P, Portner R, ym. Impact of prostate radiotherapy on survival outcomes in clinically node-positive prostate cancer: A multicentre retrospective analysis. Radiother Oncol 2023;186():»8 | 337 | Retrospective 4 centres UK | 2022-2019 | ADT +/- EBRT |
Significant benefit for combined treatment 5-yr. OS: 87% vs. 56% HR: 0.27 5-yr. BPFS: 74.1% vs. 34.2% HR: 0.33 |
| James, et al. 2022 «James ND, Ingleby FC, Clarke NW, ym. Docetaxel for Nonmetastatic Prostate Cancer: Long-Term Survival Outcomes in the STAMPEDE Randomized Controlled Trial. JNCI Cancer Spectr 2022;6(4): »10 | 258 (N1 patients) | Planned subgroup analysis RCT | 2005-2018
81.2 mo | Standard of care (ADT +/- EBRT) +/- docetaxel (EBRT planned for 55% SOC, 40% of docetaxel) | 5-year estimated
Metastatic PFS (SOC + docetaxel vs SOC, HR: 0.79) OS (RT 78% vs no RT 71%, HR: 0.77)* CSS (RT 84% vs no RT 79%, HR: 0.81)* FFS (RT 51% vs no RT 36%, HR: 0.68)* * No stratification for docetaxel use |
| Attard, et al. 2022 «Attard G, Murphy L, Clarke NW, ym. Abiraterone acetate and prednisolone with or without enzalutamide for high-risk non-metastatic prostate cancer: a meta-analysis of primary results from two randomise»11 | 774 (N1) | Planned subgroup analysis RCT | 2011-2016
72 mo | Standard of care (ADT +/- EBRT) +/- Abiraterone with or without enzalutamide
(EBRT planned for 71% of N1 patients) | MFS (SOC + Abiraterone with or without enzalutamide vs SOC alone, HR: 0.49, 95% CI: 0.38-0.64) OS (SOC + Abiraterone with or without enzalutamide vs SOC alone, HR: 0.53, 95% CI: 0.39-0.70) |
References
- Bryant AK, Kader AK, McKay RR ym. Definitive Radiation Therapy and Survival in Clinically Node-Positive Prostate Cancer. Int J Radiat Oncol Biol Phys 2018;101:1188-1193 «PMID: 29891203»PubMed
- Sarkar RR, Bryant AK, Parsons JK ym. Association between Radical Prostatectomy and Survival in Men with Clinically Node-positive Prostate Cancer. Eur Urol Oncol 2019;2:584-588 «PMID: 31411995»PubMed
- Lin CC, Gray PJ, Jemal A ym. Androgen deprivation with or without radiation therapy for clinically node-positive prostate cancer. J Natl Cancer Inst 2015;107: «PMID: 25957435»PubMed
- Tward JD, Kokeny KE, Shrieve DC. Radiation therapy for clinically node-positive prostate adenocarcinoma is correlated with improved overall and prostate cancer-specific survival. Pract Radiat Oncol 2013;3:234-240 «PMID: 24674370»PubMed
- Rusthoven CG, Carlson JA, Waxweiler TV ym. The impact of definitive local therapy for lymph node-positive prostate cancer: a population-based study. Int J Radiat Oncol Biol Phys 2014;88:1064-73 «PMID: 24661660»PubMed
- Seisen T, Vetterlein MW, Karabon P ym. Efficacy of Local Treatment in Prostate Cancer Patients with Clinically Pelvic Lymph Node-positive Disease at Initial Diagnosis. Eur Urol 2018;73:452-461 «PMID: 28890245»PubMed
- James ND, Spears MR, Clarke NW ym. Failure-Free Survival and Radiotherapy in Patients With Newly Diagnosed Nonmetastatic Prostate Cancer: Data From Patients in the Control Arm of the STAMPEDE Trial. JAMA Oncol 2016;2:348-57 «PMID: 26606329»PubMed
- Elumalai T, Maitre P, Portner R, ym. Impact of prostate radiotherapy on survival outcomes in clinically node-positive prostate cancer: A multicentre retrospective analysis. Radiother Oncol 2023;186():109746 «PMID: 37330057»PubMed
- Chierigo F, Borghesi M, Würnschimmel C, ym. Survival after radical prostatectomy versus radiation therapy in clinical node-positive prostate cancer. Prostate 2022;82(6):740-750 «PMID: 35226380»PubMed
- James ND, Ingleby FC, Clarke NW, ym. Docetaxel for Nonmetastatic Prostate Cancer: Long-Term Survival Outcomes in the STAMPEDE Randomized Controlled Trial. JNCI Cancer Spectr 2022;6(4): «PMID: 35877084»PubMed
- Attard G, Murphy L, Clarke NW, ym. Abiraterone acetate and prednisolone with or without enzalutamide for high-risk non-metastatic prostate cancer: a meta-analysis of primary results from two randomised controlled phase 3 trials of the STAMPEDE platform protocol. Lancet 2022;399(10323):447-460 «PMID: 34953525»PubMed