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KMID : 1038620150330010021
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Radiation Oncology Journal
2015 Volume.33 No. 1 p.21 ~ p.28
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Clinical and biochemical outcomes of men undergoing radical prostatectomy or radiation therapy for localized prostate cancer
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David Schreiber
Justin Rineer
Jeffrey P. Weiss
Joseph Safdieh
Joseph Weiner
Marvin Rotman
David Schwartz
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Abstract
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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.
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KEYWORD
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Prostate cancer, Radiation therapy, Radical prostatectomy, Outcomes, Dose escalation, Comparative effectiveness
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