Korean J Urol Oncol.
2018 Dec;16(3):126-134. 10.22465/kjuo.2018.16.3.126.
Prostatectomy Provides Better Symptom-Free Survival Than Radiotherapy Among Patients With High-Risk or Locally Advanced Prostate Cancer After Neoadjuvant Hormonal Therapy
- Affiliations
-
- 1Department of Urology, Center for Prostate Cancer, National Cancer Center Hospital, Goyang, Korea. uroonco@ncc.re.kr
- 2Biometrics Research Branch and Biostatistics Collaboration Unit, National Cancer Center Hospital, Goyang, Korea.
- 3Health Insurance Policy Research Institute, National Health Insurance Service, Wonju, Korea.
- 4Department of Pathology, Center for Prostate Cancer, National Cancer Center Hospital, Goyang, Korea.
- KMID: 2438606
- DOI: http://doi.org/10.22465/kjuo.2018.16.3.126
Abstract
- PURPOSE
The purpose of this study is to compare the radiation therapy (RT) and radical prostatectomy (RP) of high-risk or locally advanced prostate cancer (PC) patients after neoadjuvant hormonal therapy (NHT).
MATERIALS AND METHODS
This retrospective study evaluated patients underwent RT (42 patients) or RP (152 patients) after NHT at a single center during 2003-2014. Times to biochemical recurrence (BCR), pelvic local recurrence (PLR), metastasis, clinical painful symptom progression (CPSP), castration-resistant PC (CRPC), and overall survival were compared between the RT and RP groups, after adjustment for TN stage, using the Kaplan-Meier method and log-rank test.
RESULTS
Significant inter-group differences were observed for age, Gleason score, initial PSA, and clinical and pathological T stages (all p < 0.05). During a median follow-up of 71.7 months, the overall incidences of BCR, PLR, metastasis, CPSP, CRPC, and death were 49.5%, 16.5%, 8.3%, 7.7%, 7.7%, and 17.5%, respectively. The median times to BCR were 100 months for RT and 36.2 months for RP (p=0.004), although the median times were not reached for the other outcomes (all p>0.05). The independent predictor of CPSP was RP (hazard ratio, 0.291; p=0.013).
CONCLUSIONS
Despite significantly different baseline parameters, RP provided better CPSP-free survival than RT among patients with localized high-risk or locally advanced PC.
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