Abstract
Purpose
We retrospectively compared the treatment outcomes of localized prostate cancer between radical prostatectomy (RP) and external beam radiotherapy (EBRT).
Materials and methods
We retrospectively analyzed 738 patients with localized prostate cancer who underwent either RP (n = 549) or EBRT (n = 189) with curative intent at our institution between March 2001 and December 2011. Biochemical failure was defined as a prostate-specific antigen (PSA) level of ≥ 0.2 ng/ml in the RP group and the nadir of + ≥ 2 ng/ml in the EBRT group.
Results
The median (range) follow-up duration was 48.8 months (0.7–133.2 months) and 48.7 months (1.0–134.8 months) and the median age was 66 years (45–89 years) and 71 years (51–84 years; p < 0.001) in the RP and EBRT groups, respectively. Overall, 21, 42, and 36 % of patients in the RP group, and 15, 27, and 58 % of patients in the EBRT group were classified as low, intermediate, and high risk, respectively (p < 0.001). Androgen-deprivation therapy was more common in the EBRT group (59 vs. 27 %, respectively; p < 0.001). The 8-year biochemical failure-free survival rates were 44 and 72 % (p < 0.001) and the disease-specific survival rates were 98 % and 97 % (p = 0.543) in the RP and EBRT groups, respectively.
Conclusions
Although the EBRT group included more high-risk patients than did the RP group, the outcomes of EBRT were not inferior to those of RP. Our data suggest that EBRT is a viable alternative to RP for treating localized prostate cancer.
Zusammenfassung
Ziel
Wir vergleichen retrospektiv die Verfahrensergebnisse des lokal begrenzten Prostatakarzinoms zwischen radikaler Prostatektomie (RP) und externer Strahlentherapie (EBRT).
Material und Methoden
Wir analysieren zurückblickend 738 Patienten mit lokal begrenztem Prostatakarzinom, die zwischen März 2001 und Dezember 2011 in unserem Institut entweder eine RP (n = 549) oder eine EBRT (n = 189) mit kurativer Intention durchliefen. Biochemischer Fehler wurde als prostataspezifisches Antigen (PSA) ≥ 0,2 ng/ml in der RP-Gruppe und ein Nadir + ≥ 2 ng/ml in EBRT-Gruppe definiert.
Ergebnisse
Die mediane Follow-up-Dauer betrug in der RP- bzw. der EBRT-Gruppe jeweils 48,8 Monate (Spanne 0,7–133,2 Monate) bzw. 48,7 Monate (Spanne 1,0–134,8 Monate) und das mittlere Alter 66 Jahre (Spanne 45–89 Jahre) bzw. 71 Jahre (Spanne 51–84 Jahre; p < 0,001). Insgesamt 21, 42, und 36 % der Patienten in der RP-Gruppe und 15, 27, und 58 % der Patienten in der EBRT-Gruppe waren jeweils klassifiziert als niedriges, mittleres bzw. hohes Risiko (P < 0,001). Eine Androgendeprivationstherapie war in der EBRT-Gruppe üblicher (59 vs. 27 %; p < 0,001). Die biochemischen fehlerfreien 8-Jahres-Überlebensraten lagen in der RP- bzw. der EBRT-Gruppe jeweils bei 44 und 72 % (p < 0,001) und die krankheitsspezifischen Überlebensraten bei 98 und 97 % (p = 0,543).
Schussfolgerung
Obwohl die EBRT-Gruppe mehr Hochrisiko-Patienten als die RP-Gruppe umfasste, waren die Ergebnisse der EBRT nicht minderwertig zu den der RP. Unsere Daten weisen darauf hin, dass EBRT für das lokal begrenzte Prostatakarzinom eine verfügbare Alternative ist.
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Acknowledgments
This study was supported by Grant No.1010480 from the National Cancer Center, Korea.
Conflict of interest
Y-J. Kim, K.H. Cho, H.R. Pyo, K.H. Lee, S.H. Moon, T.H. Kim, K.H. Shin, J-Y. Kim, Y-K. Kim, and S.B. Lee state that there are no conflicts of interest.
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Kim, YJ., Cho, K., Pyo, H. et al. Radical prostatectomy versus external beam radiotherapy for localized prostate cancer. Strahlenther Onkol 191, 321–329 (2015). https://doi.org/10.1007/s00066-014-0765-3
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DOI: https://doi.org/10.1007/s00066-014-0765-3