Radical prostatectomy versus external beam radiotherapy for localized prostate cancer.

Kim, Yeon-Joo; Cho, Kwan Ho; Pyo, Hong Ryull; Lee, Kang Hyun; Moon, Sung Ho; Kim, Tae Hyun; Shin, Kyung Hwan; Kim, Joo-Young; Kim, Young-kyung; Lee, Se Byeong

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.

Strahlentherapie und Onkologie, 2015, Vol 191, Issue 4, p321

0179-7158

Academic Journal

10.1007/s00066-014-0765-3