{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:23:30Z","timestamp":1791869010726,"version":"4.3.4"},"reference-count":28,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"20","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2021,7,10]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p>Adjuvant compared with early salvage radiation therapy (sRT) following radical prostatectomy (RP) has not been shown to reduce progression-free survival in randomized controlled trials. However, these trials might have missed a benefit in men with adverse pathology at RP given that these men were under-represented and immortal time bias might have been present; herein, we investigate this possibility.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>We evaluated the impact of adjuvant versus early sRT on all-cause mortality (ACM) risk in men with adverse pathology defined as positive pelvic lymph nodes (pN1) or pGleason score 8-10 prostate cancer (PC) and disease extending beyond the prostate (pT3\/4). We used a treatment propensity score to minimize potential treatment selection bias when estimating the causal effect of adjuvant versus early sRT on ACM risk and a sensitivity analysis to assess the impact that varying definitions of adverse pathology had on ACM risk adjusting for age at RP, PC prognostic factors, site, and the time-dependent use of post-RP androgen deprivation therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>After a median follow-up (interquartile range) of 8.16 (6.00-12.10) years, of the 26,118 men in the study cohort, 2,104 (8.06%) died, of which 539 (25.62%) were from PC. After excluding men with a persistent prostate-specific antigen, adjuvant compared with early sRT was associated with a significantly lower ACM risk among men with adverse pathology at RP when men with pN1 PC were excluded (0.33 [0.13-0.85]; P = .02) or included (0.66 [0.44-0.99]; P = .04).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Adjuvant radiation therapy should be considered in men with pN1 or pGleason score 8 to 10 and pT3\/4 PC given the possibility that a significant reduction in ACM risk exists.<\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.20.03714","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T19:59:46Z","timestamp":1622836786000},"page":"2284-2293","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":109,"title":["Adjuvant Versus Early Salvage Radiation Therapy for Men at High Risk for Recurrence Following Radical Prostatectomy for Prostate Cancer and the Risk of Death"],"prefix":"10.1200","volume":"39","author":[{"given":"Derya","family":"Tilki","sequence":"first","affiliation":[{"name":"Martini-Klinik Prostate Cancer Center, University Hospital-Hamburg-Eppendorf, Hamburg, Germany"},{"name":"Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1935-2447","authenticated-orcid":false,"given":"Ming-Hui","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Statistics, University of Connecticut, Storrs, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Statistics, University of Rhode Island, Kingston, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartwig","family":"Huland","sequence":"additional","affiliation":[{"name":"Martini-Klinik Prostate Cancer 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