Objective
Brachytherapy is minimally invasive with few complications, so may be a good alternative to surgery for patients with prostate cancer. This study aimed to compare the therapeutic effects of brachytherapy and radical prostatectomy in the treatment of localized prostate cancer at different stages.
Methods
A total of 16532 patients pathologically diagnosed with prostate cancer who underwent radical prostatectomy and 16627 patients who underwent brachytherapy between 2010 and 2012 were collected through the Surveillance, Epidemiology, and End Results (SEER) Stat software. These patients were randomly matched based on age and prostate specific antigen (PSA) level at first diagnosis, and were divided into five subgroups, including G2T1c, G3T1c, G2T2a, G3T2a and G3T3b. Differences in survival were analyzed by Kaplan-Meier survival curves and compared by log-rank test.
Results
The overall survival (OS) and prostate cancer-specific death time (PCSDT) in the radical prostatectomy group at G3T1c stage were significantly longer than in the brachytherapy group (P<0.05), and OS, but not PCSDT, was longer than the brachytherapy group at G2T2a stage (P=0.02). But at the G2T1c, G3T2a and G3T3b stages OS and PCSDT were not significantly different between the two treatments (P>0.05).
Conclusion
The radical prostatectomy prognosis was superior to brachytherapy in the treatment of early-stage low-risk localized prostate cancer, whereas there was no significant difference in the prognosis of patients with moderate or high-risk localized prostate cancer.
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