Radiat Oncol J.  2015 Mar;33(1):21-28. 10.3857/roj.2015.33.1.21.

Clinical and biochemical outcomes of men undergoing radical prostatectomy or radiation therapy for localized prostate cancer

Affiliations
  • 1Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA. David.schreiber@va.gov
  • 2SUNY Downstate Medical Center, Brooklyn, NY, USA.
  • 3University of Florida Health Cancer Center at Orlando Health, Orlando, FL, USA.

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.

Keyword

Prostate cancer; Radiation therapy; Radical prostatectomy; Outcomes; Dose escalation; Comparative effectiveness

MeSH Terms

Follow-Up Studies
Humans
Kaplan-Meier Estimate
Male
Prostate
Prostatectomy*
Prostatic Neoplasms*
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