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MP53-12 EAU BCR RISK CLASSIFICATION AS DECISION TOOL FOR SALVAGE RADIOTHERAPY

INTRODUCTION AND OBJECTIVE: Recently, a new risk stratification of patients harboring biochemical recurrence (BCR) after radical prostatectomy (RP) has been proposed by the EAU: EAU lowrisk BCR (Gleason score <8 and PSA doubling time (PSADT) >12months) vs. EAU high-risk BCR (Gleason score 8 or PSADT 12months). However, whether this risk stratification may help determine patients suitable for salvage radiotherapy (SRT) remains unclear. METHODS: Retrospective analyses of 1821 RP patients who developed BCR and were treated between 1989 and 2016 (460 with SRT and 1361 without SRT) within two institutional high-volume centers. Patients with adjuvant radiotherapy (RT) or lymph node invasion were excluded. SRT was delivered to the prostatic bed in SRT patients. Kaplan-Meier curves as well as multivariable Coxregression analyses tested the effect of SRT vs. no RT on metastatic progression (MP) and overall mortality (OM) within each risk group after propensity-score matching (1:2). RESULTS: After 1:2 matching, a total of 297 patients represented the EAU lowand 972 patients the EAU high-risk BCR group. For low-risk BCR patients, 10-yr MP-free and overall survival rates were 91.3% vs. 95.1% as well as 92.1% vs. 96.2% for SRT vs. no RT patients. For high-risk BCR patients, 10-yr MP-free and overall survival rates were 84.2% vs. 81.0% as well as 87.2% vs. 81.6% for SRT vs. no RT patients. In multivariable analyses, SRT was protective only within the EAU high-risk BCR group (HR for MP: 0.48, p<0.005; HR for OM: 0.56, p[0.005). Patients considered EAU lowrisk BCR may not benefit from SRT. CONCLUSIONS: The newly proposed EAU BCR stratification may help determining patients suitable for SRT.