Clinical and biochemical outcomes of men undergoing radical prostatectomy or radiation therapy for localized prostate cancer.
- Author:
David SCHREIBER
1
;
Justin RINEER
;
Jeffrey P WEISS
;
Joseph SAFDIEH
;
Joseph WEINER
;
Marvin ROTMAN
;
David SCHWARTZ
Author Information
- Publication Type:Original Article
- Keywords: Prostate cancer; Radiation therapy; Radical prostatectomy; Outcomes; Dose escalation; Comparative effectiveness
- MeSH: Follow-Up Studies; Humans; Kaplan-Meier Estimate; Male; Prostate; Prostatectomy*; Prostatic Neoplasms*
- From:Radiation Oncology Journal 2015;33(1):21-28
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: We analyzed outcomes of patients with prostate cancer undergoing either radical retropubic prostatectomy (RRP) +/- salvage radiation or definitive radiation therapy (RT) +/- androgen deprivation. MATERIALS AND METHODS: From 2003-2010 there were 251 patients who underwent RRP and 469 patients who received RT (> or =7,560 cGy) for prostate cancer. Kaplan-Meier analysis was performed with the log-rank test to compare biochemical control (bCR), distant metastatic-free survival (DMPFS), and prostate cancer-specific survival (PCSS) between the two groups. RESULTS: The median follow-up was 70 months and 61.3% of the men were African American. For low risk disease the 6-year bCR were 90.3% for RT and 85.6% for RRP (p = 0.23) and the 6-year post-salvage bCR were 90.3% vs. 90.9%, respectively (p = 0.84). For intermediate risk disease the 6-year bCR were 82.6% for RT and 59.7% for RRP (p < 0.001) and 82.6% vs. 74.0%, respectively, after including those salvaged with RT (p = 0.06). For high risk disease, the 6-year bCR were 67.4% for RT and 41.3% for RRP (p < 0.001) and after including those salvaged with RT was 67.4% vs. 43.1%, respectively (p < 0.001). However, there were no significant differences between the two groups in regards to DMPFS or PCSS. CONCLUSION: Treatment approaches utilizing RRP +/- salvage radiation or RT +/- androgen deprivation yielded equivalent DMPFS and PCSS outcomes. Biochemical control rates, using their respective definitions, appeared equivalent or better in those who received treatment with RT.
