Prostatectomy Provides Better Symptom-Free Survival Than Radiotherapy Among Patients With High-Risk or Locally Advanced Prostate Cancer After Neoadjuvant Hormonal Therapy
10.22465/kjuo.2018.16.3.126
- Author:
Sung Han KIM
1
;
Mi Kyung SONG
;
Weon Seo PARK
;
Jae Young JOUNG
;
Ho Kyung SEO
;
Jinsoo CHUNG
;
Kang Hyun LEE
Author Information
1. Department of Urology, Center for Prostate Cancer, National Cancer Center Hospital, Goyang, Korea. uroonco@ncc.re.kr
- Publication Type:Original Article
- Keywords:
Neoadjuvant;
Hormone;
Prostate cancer;
Recurrence;
Risk factor
- MeSH:
Follow-Up Studies;
Humans;
Incidence;
Methods;
Neoplasm Grading;
Neoplasm Metastasis;
Prostate;
Prostatectomy;
Prostatic Neoplasms;
Radiotherapy;
Recurrence;
Retrospective Studies;
Risk Factors
- From:Korean Journal of Urological Oncology
2018;16(3):126-134
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The purpose of this study is to compare the radiation therapy (RT) and radical prostatectomy (RP) of high-risk or locally advanced prostate cancer (PC) patients after neoadjuvant hormonal therapy (NHT). MATERIALS AND METHODS: This retrospective study evaluated patients underwent RT (42 patients) or RP (152 patients) after NHT at a single center during 2003–2014. Times to biochemical recurrence (BCR), pelvic local recurrence (PLR), metastasis, clinical painful symptom progression (CPSP), castration-resistant PC (CRPC), and overall survival were compared between the RT and RP groups, after adjustment for TN stage, using the Kaplan-Meier method and log-rank test. RESULTS: Significant inter-group differences were observed for age, Gleason score, initial PSA, and clinical and pathological T stages (all p < 0.05). During a median follow-up of 71.7 months, the overall incidences of BCR, PLR, metastasis, CPSP, CRPC, and death were 49.5%, 16.5%, 8.3%, 7.7%, 7.7%, and 17.5%, respectively. The median times to BCR were 100 months for RT and 36.2 months for RP (p=0.004), although the median times were not reached for the other outcomes (all p>0.05). The independent predictor of CPSP was RP (hazard ratio, 0.291; p=0.013). CONCLUSIONS: Despite significantly different baseline parameters, RP provided better CPSP-free survival than RT among patients with localized high-risk or locally advanced PC.
