PURPOSE/OBJECTIVES: The addition of whole pelvic (WP) compared with prostate-only (PO) @entity1161 ( @entity1161 ) for clinically node-negative @entity263 remains controversial. The purpose of our study was to evaluate the survival benefit of adding WPRT versus PO- @entity1161 for high-risk, node-negative @entity263 , using the National Cancer Data Base (NCDB). METHODS AND MATERIALS: @entity1 with high-risk @entity263 treated from 2004 to 2006, with available data for @entity1161 volume, coded as prostate and pelvis (WPRT) or prostate alone (PO- @entity1161 ) were included. Multivariate analysis (MVA) and propensity-score matched analysis (PSM) were performed. Recursive partitioning analysis (RPA) based on @entity1349 ( @entity1349 ) using Gleason score (GS), T stage, and pretreatment @entity1486 was also conducted. RESULTS: A total of 14,817 @entity1 were included: 7606 (51.3%) received WPRT, and 7211 (48.7%) received PO- @entity1161 . The median follow-up time was 81  months (range, 2-122  months). Under MVA, the addition of WPRT for high-risk @entity1 had no @entity1349 benefit compared with PO- @entity1161 (HR 1.05; P=.100). On subset analysis, @entity1 receiving dose-escalated @entity1161 also did not benefit from WPRT (HR 1.01; P=.908). PSM confirmed no survival benefit with the addition of WPRT for high-risk @entity1 (HR 1.05; P=.141). In addition, RPA was unable to demonstrate a survival benefit of WPRT for any subset. Other prognostic factors for inferior @entity1349 under MVA included older age (HR 1.25; P<.001), increasing comorbidity scores (HR 1.46; P<.001), higher T stage (HR 1.17; P<.001), @entity1486 (HR 1.81; P<.001), and GS (HR 1.29; P<.001), and decreasing median county household income (HR 1.15; P=.011). Factors improving @entity1349 included the addition of @entity342 deprivation therapy (HR 0.92; P=.033), combination external beam @entity1161 plus brachytherapy boost (HR 0.71; P<.001), and treatment at an academic/research institution (HR 0.84; P=.002). CONCLUSION: In the largest reported analysis of WPRT for @entity1 with high-risk @entity263 treated in the dose-escalated era, the addition of WPRT demonstrated no survival advantage compared with PO- @entity1161 .

Survival Outcomes of Whole-Pelvic Versus Prostate-Only Radiation Therapy for High-Risk XXXX @entity1 With Use of the National Cancer Data Base.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity263 :: ('MESH:D011471', 'Disease') :: ['prostate cancer'] @entity1161 :: ('MESH:D011832', 'Disease') :: ['radiation therapy', 'RT'] @entity342 :: ('CHEBI:50113', 'Chemical') :: ['androgen'] @entity1349 :: ('MESH:D011475', 'Disease') :: ['OS', 'overall survival'] @entity1486 :: ('354', 'Gene') :: ['prostate-specific antigen (PSA)', 'PSA']
@entity263 :: (MESH:D011471,Disease) :: ['Prostate Cancer']
