Details

Autor(en) / Beteiligte

• Urabe, Fumihiko
• Miki, Kenta
• Kimura, Takahiro
• Sasaki, Hiroshi
• Tashiro, Kojiro
• Iwatani, Kosuke
• Matsukawa, Akihiro
• Aikawa, Koichi
• Tsusumi, Yuki
• Morikawa, Midoriko
• Minato, Kyosuke
• Sato, Shun
• Takahashi, Hiroyuki
• Aoki, Manabu
• Egawa, Shin

Titel

Long‐term outcomes of radical prostatectomy versus low‐dose‐rate brachytherapy in patients with intermediate‐risk prostate cancer: Propensity score matched comparison

Ist Teil von

• The Prostate, 2023-02, Vol.83 (2), p.135-141

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2023

Quelle

Wiley Online Library - AutoHoldings Journals

Beschreibungen/Notizen

• Purpose To compare long‐term outcomes of radical prostatectomy (RP) and low‐dose‐rate brachytherapy (LDR‐BT) using propensity score‐matched analysis in patients with clinically localized, intermediate‐risk prostate cancer (PCa). Methods Between October 2003 and March 2014, our institution treated 1241 patients with intermediate‐risk PCa (RP: n = 531; LDR‐BT: n = 710). Biochemical recurrence (BCR) was defined as prostate‐specific antigen (PSA) levels of 0.2 ng/ml or greater for RP, and as PSA nadir plus 2 ng/ml or higher (Phoenix definition) for LDR‐BT. We calculated propensity scores by multivariate logistic regression based on covariates that included age, pretreatment PSA, biopsy Gleason grade, the percentage of positive biopsy cores (PPBC), and clinical T stage. Results Median follow‐up was 108 months for RP and 99 months for LDR‐BT. After propensity score adjustment, a total of 642 (321 each) patients remained for further analysis. Kaplan–Meier curves showed no statistically significant difference in overall survival (OS) (p = 0.99). LDR‐BT was associated with improved BCR‐free survival and salvage therapy‐free survival  compared to RP (p < 0.001), and RP was associated with improved metastasis‐free survival (MFS, p < 0.001). Conclusion BCR cannot be a surrogate for survival comparison, primarily due to differences between treatment modalities in how this term was defined post‐therapy. Long‐term follow‐up showed that RP was associated with lower MFS in intermediate‐risk PCa. However, this has not yet translated into superior OS.