BACKGROUND The aim of the study was to analyse the prognostic factors in postoperative prostate cancer irradiation and develop a nomogram for disease-free survival (DFS). PATIENTS AND METHODS This retrospective study included 236 consecutive prostate cancer patients who had radical prostatectomy followed by radiotherapy (RT) at a single tertiary institution between 2009 and 2014. The main outcome was DFS analysed through uni- and multivariable analysis, Kaplan-Meier curves, log-rank testing, recursive partitioning analysis, and nomogram development. RESULTS The median follow up was 62.3 (interquartile range [IQR] 38.1-79) months. The independent clinical factors associated with increased risk of recurrence or progression in the multivariate analysis (MVA) were prostate-specific antigen (PSA) level before RT, pT3 characteristic, and local failure as salvage indication. The value of PSA nadir had a significant impact on the risk of biochemical failure. Biochemical control and DFS were significantly different depending on treatment indication (p < 0.0001). The recursive partitioning analysis highlighted the importance of the PSA level before RT, Gleason Grade Group, PSA nadir, and local failure as a treatment indication. Finally, the nomogram for DFS was developed and is available online at https://apps.konsta.com.pl/app/prostate-salvage-dfs/. CONCLUSIONS The Pre-RT PSA level, pT3 characteristic and local failure as salvage indication are pivotal prognostic factors associated with increased risk of recurrence or progression. The Gleason grade group of 4-5 and PSA nadir value allow for further risk stratification. The treatment outcomes in postoperative prostate cancer irradiation are significantly different depending on treatment indication. An online nomogram comprising of both pre-treatment and current data was developed allowing for visualization of changes in prognosis depending on clinical data.

中文翻译：

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前列腺癌术后放疗的预后因素-第三中心的经验。

背景技术这项研究的目的是分析术后前列腺癌照射的预后因素，并开发出无病生存期（DFS）的诺模图。患者与方法这项回顾性研究纳入了236位在2009年至2014年间连续接受前列腺癌根治术并接受放射治疗（RT）的连续前列腺癌患者。主要结果是通过单因素和多因素分析，Kaplan-Meier曲线，对数秩测试，递归分区分析和列线图开发。结果中位随访时间为62.3（四分位间距[IQR] 38.1-79）个月。多因素分析（MVA）中与复发或进展风险增加相关的独立临床因素是RT之前的前列腺特异性抗原（PSA）水平，pT3特征，和局部故障作为打捞的迹象。PSA最低值的值对生化失败的风险有重大影响。根据治疗适应症，生化对照和DFS显着不同（p <0.0001）。递归分区分析强调了在RT，Gleason评分组，PSA最低点和局部衰竭之前将PSA水平作为治疗指标的重要性。最后，开发了DFS的列线图，并可以从https://apps.konsta.com.pl/app/prostate-salvage-dfs/在线获取。结论RT-Pre PSA水平，pT3特征和局部失败作为挽救指征是与复发或进展风险增加相关的关键预后因素。格里森（Gleason）4-5级组和PSA最低值允许进一步的风险分层。术后前列腺癌放疗的治疗结果根据治疗适应症而有显着差异。开发了包含治疗前数据和当前数据的在线列线图，可以根据临床数据可视化预后的变化。