Comparison of the Biochemical Recurrence risk between Radical Prostatectomy and Brachytherapy in the treatment of low- and intermediate-risk prostate cancer.

To evaluate the results of patients treated with Radical Prostatectomy (RP) and Brachytherapy for low- and intermediate-risk localized prostate cancer and to determine the Biochemical Recurrence (BCR) risk according to the treatment performed.

The study included 129 patients treated with iodine-125 seeds Brachytherapy, 98 patients treated with Laparoscopic RP (LRP), and 61 patients treated with Robotic RP (RRP) at our institution between December 1999 and January 2010, who had a low-risk disease according to D'Amico criteria (PSA 10 and < 20 ng/mL, Gleason = 7, cT2b), but with a tumor burden of up to 30%. Follow-up was conducted with PSA at 1, 3, and 6 months, and then every six months. As for Brachytherapy, annual digital rectal examinations were also performed. A PSA level increase of 2 ng/mL above the nadir in Brachytherapy (confirmed in 2 cases) and a PSA value greater than 0. 2 ng/mL after RP were considered BCR.

Overall mean follow-up was 60. 5 months (R:1-152), with a mean time for BCR of 51. 7 months (R:1-138). Estimated 5-year Biochemical Recurrence-free Survival (BCRFS) in patients with D'Amico low-risk was 85. 7%, 77. 2% and 90. 7% (p 0. 336), while for intermediate-risk it was 75. 8%, 68. 1% and 65. 1% (p 0. 114), for Brachytherapy, LRP and RRP respectively. In the univariate analysis, the Gleason score 7, a clinical stage T2b, and a D'Amico intermediate-risk were associated with an increased BCR risk, and treatment with Brachytherapy was associated with a decreased BCR risk, all these being statistically significant. In the multivariate analysis, only the Gleason score 7 was significant; treatment with LRP, RRP or Brachytherapy was not associated with a greater BCR risk.

Brachytherapy and Laparoscopic or Robotic Radical Prostatectomy showed no difference in terms of Biochemical Recurrence risk in patients treated for low-risk or intermediate-risk tumors, with low tumor volume.

Archivos espanoles de urologia. 2015 Oct [Epub]

P F Martínez, D F Belisle, C Cristallo, I Tobía, O Damia, W Villamil, C R Giudice

Service of Urology. Hospital Italiano de Buenos Aires. Argentina. , Service of Urology. Hospital Italiano de Buenos Aires. Argentina. , Service of Urology. Hospital Italiano de Buenos Aires. Argentina. , Service of Urology. Hospital Italiano de Buenos Aires. Argentina. , Service of Urology. Hospital Italiano de Buenos Aires. Argentina. , Service of Urology. Hospital Italiano de Buenos Aires. Argentina. , Service of Urology. Hospital Italiano de Buenos Aires. Argentina.

PubMed

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