Clinical and biochemical outcomes of men undergoing radical prostatectomy or radiation therapy for localized prostate cancer

다국어 초록 (Multilingual Abstract)

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.

목차 (Table of Contents)

• 1. Introduction
• 2. Materials and Methods
• 3. Results
• 4. Discussion and Conclusion
• 5. Conflict of Interest
• 6. References

참고문헌 (Reference)

1 Cookson MS, "Variation in the definition of biochemical recurrence in patients treated for localized prostate cancer: the American Urological Association Prostate Guidelines for Localized Prostate Cancer Update Panel report and recommendations for a standard in the reporting of surgical outcomes" 177 : 540-545, 2007

2 Kupelian PA, "Radical prostatectomy, external beam radiotherapy < 72 Gy, external beam radiotherapy > or = 72 Gy, permanent seed implantation, or combined seeds/external beam radiotherapy for stage T1-T2prostate cancer" 58 : 25-33, 2004

3 Aizer AA, "Radical prostatectomy vs. intensity-modulated radiation therapy in the management of localized prostate adenocarcinoma" 93 : 185-191, 2009

4 Rayala HJ, "Radical prostatectomy reigns supreme" 23 : 863-867, 2009

5 Surapaneni A, "Radiation therapy for clinically localized prostate cancer: long-term results of 469 patients from a single institution in the era of dose escalation" 10 : 951-956, 2014

6 Du XL, "Racial disparity and socioeconomic status in association with survival in older men with local/regional stage prostate carcinoma: findings from a large community-based cohort" 106 : 1276-1285, 2006

7 Tewari A, "Racial differences in serum prostate-specific antigen (PSA) doubling time, histopathological variables and long-term PSA recurrence between African-American and white American men undergoing radical prostatectomy for clinically localized prostate cancer" 96 : 29-33, 2005

8 Klein EA, "Outcomes for intermediate risk prostate cancer: are there advantages for surgery, external radiation, or brachytherapy?" 27 : 67-71, 2009

9 "National Comprehensive Cancer Network; c2015" National Comprehensive Cancer Network guidelines on prostate cancer

10 Potters L, "Monotherapy for stage T1-T2 prostate cancer: radical prostatectomy, external beam radiotherapy, or permanent seed implantation" 71 : 29-33, 2004

11 Joseph J. Safdieh, "Long-term tolerance and outcomes for dose escalation in early salvage post-prostatectomy radiation therapy" 대한방사선종양학회 32 (32): 179-186, 2014

12 Cross CK, "Impact of race on prostate-specific antigen outcome after radical prostatectomy for clinically localized adenocarcinoma of the prostate" 20 : 2863-2868, 2002

13 Du KL, "Impact of marital status and race on outcomes of patients enrolled in Radiation Therapy Oncology Group prostate cancer trials" 20 : 1317-1325, 2012

14 Vassil AD, "Five year biochemical recurrence free survival for intermediate risk prostate cancer after radical prostatectomy, external beam radiation therapy or permanent seed implantation" 76 : 1251-1257, 2010

15 Chu DI, "Effect of race and socioeconomic status on surgical margins and biochemical outcomes in an equal-access health care setting: results from the Shared Equal Access Regional Cancer Hospital (SEARCH)database" 118 : 4999-5007, 2012

16 Chornokur G, "Disparities at presentation, diagnosis, treatment, and survival in African American men, affected by prostate cancer" 71 : 985-997, 2011

17 Shah C, "Differences in disease presentation, treatment outcomes, and toxicities in African American patients treated with radiation therapy for prostate cancer" 35 : 566-571, 2012

18 Roach M 3rd, "Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer:recommendations of the RTOG-ASTRO Phoenix Consensus Conference" 65 : 965-974, 2006

19 Nielsen ME, "Black race does not independently predict adverse outcome following radical retropubic prostatectomy at a tertiary referral center" 176 : 515-519, 2006

20 D'Amico AV, "Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer" 280 : 969-974, 1998

21 Sundi D, "African American men with very low-risk prostate cancer exhibit adverse oncologic outcomes after radical prostatectomy: should active surveillance still be an option for them?" 31 : 2991-2997, 2013