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KMID : 1001020180160030126
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Journal of Urologic Oncology
2018 Volume.16 No. 3 p.126 ~ p.134
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Prostatectomy Provides Better Symptom-Free Survival Than Radiotherapy Among Patients With High-Risk or Locally Advanced Prostate Cancer After Neoadjuvant Hormonal Therapy
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Kim Sung-Han
Song Mi-Kyung
Park Weon-Seo
Joung Jae-Young
Seo Ho-Kyung
Chung Jin-Soo
Lee Kang-Hyun
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Abstract
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Purpose: The purpose of this study is to compare the radiation therapy (RT) and radical prostatectomy (RP) of high-risk or locally advanced prostate cancer (PC) patients after neoadjuvant hormonal therapy (NHT).
Materials and Methods: This retrospective study evaluated patients underwent RT (42 patients) or RP (152 patients) after NHT at a single center during 2003?2014. Times to biochemical recurrence (BCR), pelvic local recurrence (PLR), metastasis, clinical painful symptom progression (CPSP), castration-resistant PC (CRPC), and overall survival were compared between the RT and RP groups, after adjustment for TN stage, using the Kaplan-Meier method and log-rank test.
Results: Significant inter-group differences were observed for age, Gleason score, initial PSA, and clinical and pathological T stages (all p＜0.05). During a median follow-up of 71.7 months, the overall incidences of BCR, PLR, metastasis, CPSP, CRPC, and death were 49.5%, 16.5%, 8.3%, 7.7%, 7.7%, and 17.5%, respectively. The median times to BCR were 100 months for RT and 36.2 months for RP (p=0.004), although the median times were not reached for the other outcomes (all p＞0.05). The independent predictor of CPSP was RP (hazard ratio, 0.291; p=0.013).
Conclusions: Despite significantly different baseline parameters, RP provided better CPSP-free survival than RT among patients with localized high-risk or locally advanced PC.
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KEYWORD
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Neoadjuvant, Hormone, Prostate cancer, Recurrence, Risk factor
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