S1172
Clinical - Urology
ESTRO 2026
without intervention, recorded only if before recurrence) or BCR (Phoenix criteria). Study endpoints included biochemical recurrence-free survival (BRFS), distant metastasis-free survival (DMFS), and overall survival (OS). Multivariable Cox regression was used to identify outcome predictors, significance defined as p<0.05, and assumptions verified using scaled Schoenfeld residuals. Results: Of 23,848 initially retrieved patients, 2,182met selection criteria. Median age was 71 years (IQR 65-76), median follow-up of 105 months (IQR 77-147), 30% had high/very high-risk disease, received photon EBRT (71%), and half (49%) received ADT. PSA bounceoccurred in 512 patients (23.5%) at a median
time of 15.2 (IQR 10.4-24.8) months from radiotherapy, with 109 patients (21.3%) later
developing recurrence. BCRoccurred in 1,049patients at a median time of 98.6 (95% CI, 94.7-104.1) months. Imaging or biopsy confirmed recurrence occurred before Phoenix Criteria PSA threshold in 112 patients. Distant metastasis occurred in 523 patients at a median time of 151.5 (95% CI, 146.6-157.5) months.During follow-up, 840 patients died (50.5% PCa-related deaths), median OS was 177.1 (95% CI, 171.7-185.7)months. Multivariable analysis demonstrated PSA bounce independently predicted improvedBRFS (HR 0.37, 95% CI 0.32-0.43, p<0.001) and DMFS (HR 0.67, 95% CI 0.57-0.8, p<0.001). PSA bounce was not significantly associated with OS (HR 0.84, 95% CI 0.69-1.01, p=0.064).
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