I would just like to second what Aprilsunny wrote. I read a lot about this subject, having quite a bit at stake being a youngish patient (47 now) who has gone through salvage radiation.
"I see a lot about Salvage radiation and Adjuvant Radiation information regarding signifcantly better Biochemical recurrence data but have not seen where the overall survival and distant metastasis is significantly different statistically with versus without treatment. Is anybody else finding this or does anybody know that overall survival is statistically better with treatment?"
As to that specific question, the most relevant information I've seen is the article "Prostate Cancer–Specific Survival Following Salvage Radiotherapy vs Observation in Men With Biochemical Recurrence After Radical Prostatectomy" available in full text, for free at: http://jama.ama-assn.org/cgi/content/full/299/23/276
The lead author was Trock of Johns Hopkins Brady Institute and the co-authors, as Aprilsunny pointed out, are an impressive list: Han, Freedland, Humphreys, DeWeese, Partin, and Walsh.
Their analysis indicates that it is men with fast doubling times who appear to benefit the most, in terms of survival, from SRT. (Which, by the way was good news to me, since my PSADT was pretty fast, less than 90 days).
Dr. Catalona wrote about this study, and others, in one of his excellent newsletter articles, "To Do or Not to Do: Radiation After a Radical Prostatectomy" http://www.drcatalona.com/quest/quest_winter08_2.htm . An excerpt from Dr. Catalona:
"Possibly, the men with slower doubling times have less aggressive cancers with less need for salvage radiation. But it is also possible, and even likely, that with longer follow-up, men with slower PSA doubling times will be shown to receive a survival advantage from SRT as well.
In their article, researchers said, 'This study provides provocative evidence that even men with adverse prognostic features such as rapid PSA doubling time or high Gleason score may benefit from salvage radiotherapy'.
Before this study, the prevailing theory was that recurrence was evidence the cancer had metastasized in some other place or places in the body. This finding, they said, 'If true, has somewhat surprising implications for the prevalence of local recurrence as a source of PSA relapse'.
Additional findings suggested that men for whom salvage radiotherapy is most beneficial are those with a PSA doubling time of less than 6 months, who also undergo treatment within 2 years of an increase in PSA level and before the PSA reaches 2." (End quote).
So to me, things look promising in terms of actual survival, but the answer is not clear yet. One sobering fact is that so far, in the long run, according to Catalona, Andrew Stephenson, and others, more men have BCR than not after salvage radiation. At the 10 year mark, only 25-35% of men are still free from PSA progression following salvage. The percentage starts out much higher--about 3/4 of men are responders to SRT, but that drops to around 50% at 5 years (hence the "50/50" statement so often used about SRT) and then it continues to drop after that. Hopefully the stats will start to show better results, as time goes by, due to better radiation techniques. Time will tell.
I've put together a brief guide that encapsulates what I have read about salvage radiation. It's here: http://knol.google.com/k/salvage-radiation-for-prostate-cancer
Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 and thereafter <0.1