Radical Prostatectomy or Radiotherapy for High and Very High Risk Prostate Cancer: A Multidisciplinary Clinic Experience of Patients Eligible for Either Treatment.

To compare RP vs. RT with ADT in the setting of high and very high risk patients that were deemed eligible for either therapy and made a treatment choice after consultation in a multidisciplinary prostate cancer clinic (multi-clinic), and to compare the multi-clinic patient outcomes to a matched SEER cohort.

Prospectively collected, retrospective study comparing RP (n=231) versus RT+ADT (n=73) from 2004-2013. Biochemical recurrence (BCR), Local recurrence, Distant metastasis failure, and overall survival (OS) were calculated for each treatment group overall and according to NCCN risk strata. A propensity score matched comparison with a SEER cohort was performed for overall survival.

There was no difference in local recurrence (HR 2.7; 95%CI 1.0-7.9, p=0.06), distant metastasis failure (HR 2.5; 95%CI 0.8-7.8, p=0.1) and overall survival (HR 1.35; 0.4-4.8, p=0.6) between patients undergoing RP versus RT+ADT. Patients treated via the multi-disciplinary clinic survived on average 16.9 months (95%CI 13.1-20.8) longer than those in the SEER matched cohort.

Long-term outcomes appear similar among high and very high-risk prostate cancer patients deemed eligible for either RP or RT and treated after consultation in a multidisciplinary prostate cancer clinic. Outcomes of the multi-clinic patients were superior to those of the matched SEER cohort. This article is protected by copyright. All rights reserved.

BJU international. 2019 Apr 22 [Epub ahead of print]

Chad A Reichard, Karen E Hoffman, Chad Tang, Stephen B Williams, Pamela K Allen, Mary F Achim, Deborah A Kuban, Brian F Chapin

Departments of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX., Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX., Department of Surgery, Division of Urology, The University of Texas Medical Branch, Galveston, TX.