Little is known about the clinical impact of using multiparametric MRI to plan early salvage radiotherapy after radical prostatectomy. We aimed to evaluate the incidence and location of recurrence based on pelvic multiparametric MRI findings and to identify clinical variables predictive of positive imaging results. We defined radiological criteria of local and lymph node malignancy and reviewed records and MRI studies of 70 patients with PSA recurrence after radical prostatectomy. We performed univariate and multivariate analysis to identify any association between clinical, pathological and treatment-related variables and imaging results. Multiparametric MRI was positive in 33/70 patients. We found local and lymph node recurrence in 27 patients and 7 patients, respectively, with a median PSA value of 0.38 ng/ml. We found no statistically significant differences between patients with positive and negative multiparametric MRI for any variable. Shorter PSADT was associated with positive lymph nodes (median PSADT: 5.12 vs 12.70 months; p: 0.017). Nearly half the patients had visible disease in multiparametric MRI despite low PSA. Positive lymph nodes incidence should be considered when planning salvage radiotherapy, particularly in patients with a short PSADT.

Background: The clinical outcome of inoperable sarcoma patients treated with LATTICE (LRT) is limited and therefore the objective of our study was to report treatment response, overall survival (OS), local-recurrence free survival (LRFS) and toxicity. Methods: This retrospective observational study includes 15 histologically proven inoperable non-extremity sarcoma patients with no treatment options or no response to systemic therapy, treated at our institution between 2020 and 2024. The patients were treated with a combination of LRT and normo- or hypo-fractionated external beam radiotherapy. Treatment response was evaluated by RECIST1.1 criteria, toxicity by CTCAE 5.0 and OS and LRFS by Kaplan–Meier curves. Results: The median follow-up (F-UP) since the beginning of the treatment was 10 months (range 4–32). Nine patients were male and six female. Their mean age was 60 years. The median gross tumor volume (GTV) was 1058 cm³ (range 142–6103 cm³). The median number of spheres was 9 (4–30). All patients with symptoms reported symptoms’ relief. Based on RECIST1.1 criteria, 10 patients (67%) had stable local disease at 1–2 months F-UP on computed tomography (CT). Surgical resection was feasible in five patients. Three of them are alive without disease and two died due to metastatic progression. From 10 (67%) non operated patients, 5 patients died (50%) due to disease. The remaining five patients (50%) are alive, three with stable disease at 21, 22, and 32 months of F-UP and two with disease progression who are currently receiving palliative chemotherapy treatment. Reported G2 toxicity was as follows: gastrointestinal (2), asthenia (1). Two patients had G3 toxicity: esophagitis (1) and inguinal dermatitis (1). No acute or chronic G4–G5 toxicity was observed. Conclusions: LRT is a feasible and well-tolerated radiation technique for inoperable bulky soft-tissue sarcomas. Further studies are needed to establish protocols to determine which patients could benefit from palliative or preoperative treatment.