Local Failure and Survival After Definitive Radiotherapy for Aggressive Prostate Cancer: An Individual Patient-level Meta-analysis of Six Randomized Trials (European Urology)
Using individual patient-level data from six randomized trials, we have found that local failure events after definitive radiotherapy for high-grade prostate cancer are independent, significant predictors of distant metastasis-free survival, prostate cancer-specific survival, and overall survival. Using multistate modeling, we identify that most distant metastatic events occur from an apparent disease-free state, but an increasing proportion occurs over time subsequent to local failure events.