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

Written by:
Schreiber D, Rineer J, Weiss JP, Safdieh J, Weiner J, Rotman M, Schwartz D.   Are you the author?
Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA; SUNY Downstate Medical Center, Brooklyn, NY, USA; University of Florida Health Cancer Center at Orlando Health, Orlando, FL, USA.

Reference: Radiat Oncol J. 2015 Mar;33(1):21-8.
doi: 10.3857/roj.2015.33.1.21

PubMed Abstract
PMID: 25874174 Prostate Cancer Section