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Radical prostatectomy versus external beam radiotherapy for localized prostate cancer

Comparison of treatment outcomes

Radikale Prostatektomie versus externe Strahlentherapie beim lokal begrenzten Prostatakarzinom

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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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Compliance with ethical guidelines

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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Authors and Affiliations

  1. Research Institute and Hospital, National Cancer Center, Goyang, Korea

    Yeon-Joo Kim M.D., Kwan Ho Cho M.D., Kang Hyun Lee M.D., Sung Ho Moon M.D., Tae Hyun Kim M.D., Kyung Hwan Shin M.D., Joo-Young Kim M.D., Young-kyung Kim M.D. & Se Byeong Lee Ph.D.

  2. Department of Radiation Oncology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea

    Hong Ryull Pyo M.D.

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  1. Yeon-Joo Kim M.D.
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  6. Tae Hyun Kim M.D.
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  8. Joo-Young Kim M.D.
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  9. Young-kyung Kim M.D.
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Correspondence to Kwan Ho Cho M.D..

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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

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