A total of 277 patients with apparently localised prostatic cancer (T2-T4 NXMO) were allocated at random to receive radiotherapy alone (88), orchiectomy alone (90) and combined therapy (99) between 1980 and 1985. The main outcome measures were survival, time to appearance of metastases and treatment of local disease progression by further transurethral resection. Orchiectomy, whether alone or with radiotherapy, produced a significant delay in detection of metastases when compared with radiotherapy alone. There were no statistically significant differences between the 3 treatment groups in local disease control or in overall survival.
objective of this study was to assess sPC detection rates of TB and TS in prospectively randomized men.METHODS: Using a noninferiority margin of 5% and a onesided alpha level of 5%, the randomization of 170 men (n[85 in each group) provides the trial with 80% power. All men underwent either TB or TS in addition to 24 systematic cores. Cancer and sPC (International Society of Urological Pathology grade group >[2) detection rates were analysed. Cancer detection rates were calculated for TS, TB, and SB at both lesion and patient level. Combination of SB þ TB or TS served as reference. The detection difference of TS and TB was estimated by the means of a generalized linear mixed (GLM) model and a t-test for independent samples. Intrapatient statistical differences in sPC detection for patient-and lesion-level were calculated using McNemar's tests with confidence intervals.RESULTS: 53 men (62%) in the TB and 69 men (81%) in the TS group harbored PC. sPC was detected in 42% of men in the TB and 67% in the TS group. SB detected 86% (in TB group) and 82% (in TS group) of men with sPC. TB detected 92% of men and 86% of lesions harboring sPC, whereas TS detected all men and 97% of sPC lesions. Comparing detection rates, TS was 8% in favor over TB (p[0.03) on patient level and 11% (p[0.04) on lesion level.CONCLUSIONS: Overall, data of this prospective randomized study demonstrate a higher sPC detection rate using a TS approach as compared to conventional TB in MRI/TRUS-fusion biopsy.
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