Radical Prostatectomy versus External Beam Radiotherapy for cT1-4N0M0 Prostate Cancer: Comparison of Patient Outcomes Including Mortality

Taguchi, Satoru; Fukuhara, Hiroshi; Shiraishi, Kenshiro; Nakagawa, Keiichi; Morikawa, Teppei; Kakutani, Shigenori; Takeshima, Yuta; Miyazaki, Hideyo; Fujimura, Tetsuya; Nakagawa, Tohru; Kume, Haruki; Homma, Yukio

doi:10.1371/journal.pone.0141123

Cited by 14 publications

(11 citation statements)

References 20 publications

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“…The success in BRFS with high-dose in RT was not achieved in terms of OS. In agreement with other studies 14 , 16 , 17 , 20 - 22 , mean age at diagnosis in patients receiving RT in our study was significantly higher than that in patients receiving RP. Patients receiving RP were generally in the low and intermediate risk groups, and those undergoing RT were more populated in the high risk group.…”

Section: Discussionsupporting

confidence: 93%

“…The low risk group had the highest age at diagnosis in the RT arm in our study, and also the highest mortality rates Analysis of causes of death revealed that patients in the low risk group died from chronic diseases and other causes. Similar studies have also frequently reported deaths unrelated to prostate cancer among causes of death in the RT arm 16 , 17 , 23 , 24 .…”

Section: Discussionsupporting

confidence: 68%

“…Taguchi et al 16 retrospectively investigated 891 T1-T4N0M0 patients receiving RP and RT in terms of clinical stages. Patients in the RT arm received a mean dose of 76 Gy RT.…”

Section: Discussionmentioning

confidence: 99%

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An evaluation of response to therapy in patients undergoing radiotherapy or surgery in the treatment of prostate cancer

Zortul

Ozmen

Demirdöğen

2019

MMJ

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Objective: This study compared biochemical recurrence (BR), biochemical recurrence-free survival (BRFS) and overall survival (OS) rates and therapeutic methods in patients undergoing definitive radiotherapy (RT) or radical prostatectomy (RP) because of diagnosis of prostate cancer. Method: Files of 128 patients undergoing RP (n=82) or RT (n=46), who did not receive salvage therapy, and with serum PSA levels monitored three-monthly for at least two years were examined retrospectively. Patients were assigned into low, intermediate and high risk groups based on D'Amico risk classifications. RP was performed in the surgical arm and in the RT arm 70-74 Gy RT were applied using 3D conformal RT technique. Results: BR was not detected among low risk group patients over 10-year follow-up. No difference was determined between the treatment arms in BR in the intermediate risk patients, while the RT arm was statistically significantly better among the high risk patients (p=0.04). OS rates in the low, intermediate, and high risk groups were 97.1%, 93.8%, and 92.3%, respectively, in the RP, and 81.8%, 92.9%, and 90.5%, respectively, in RT (p>0.05) group. BRFS rates in the intermediate and high risk groups were 92.3%, vs 95.2% in RP, and 79.6%, vs 81.6% in RT (p>0.05). Conclusion: There was no significant difference between BRFS and OS rates in the two arms of prostate cancer treatment, although RT was better in the high risk group patients in terms of BR. Longer-term studies involving high-dose RT techniques applied with maximum protection of normal tissue and supporting the effectiveness of RT are needed.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 68%

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An evaluation of response to therapy in patients undergoing radiotherapy or surgery in the treatment of prostate cancer

Zortul

Ozmen

Demirdöğen

2019

MMJ

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“…How patients with GP5 or those with a high probability of having GP5 can be treated? We have previously investigated the clinical significance of salvage RT and salvage ADT for locally advanced PC (19)(20)(21). Men in the high-risk group that received RP following radiotherapy had significantly better cancer-specific and overall survival outcomes than patients who had firstly received radiotherapy (19).…”

Section: Discussionmentioning

confidence: 99%

Aggressive Cancer Behavior of Latent Gleason Pattern 5 in Prostatectomy Specimens

et al. 2018

Self Cite

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Background/Aim: The aim of this study was to demonstrate the clinical significance of latent Gleason pattern (GP) 5 occasionally found in prostatectomy specimens. Materials and Methods: Patients (n=605) undergoing radical prostatectomy were classified into three groups according to the presence of GP5 in the biopsy or in the prostatectomy specimens: 'GP5 negative' , absence of GP in both specimens 'latent GP5', absence of GP5 in the biopsy specimen, but presense of GP5 in the prostatectomy specimen, and 'GP5 positive', presense of GP in both specimens. The characteristics of these three groups were analyzed. Results: There were 381 men in the GP5-negative group, 155 in the latent GP5 group, and 69 in the GP5positive group. Low-or intermediate-risk for prostate cancer, latent GP5 and surgical margin positivity were independent predictors of biochemical recurrence (Hazard ratio (HR): 3.1, 5.8, respectively, p=0.001, 0.0002, respectively). Conclusion: Latent GP5 is an important prognostic factor that should be evaluated in patients with low-and intermediate-risk for prostate cancer before the initiation of treatment.

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“…The OR of 2-year and 5-year BDFS also showed a better result among patients received EBRT, which was consistent with subgroup analyses of risk stratification. The different nadir levels were used in defining the biochemical failure, the post-radiotherapy patients were regarded as biochemical failure with higher PSA level, thus the result of BDFS might not reflect the mortality [ 20 ]. And the higher rate of biochemical failure for postoperative patients might contribute to the higher use of salvage therapies.…”

Section: Discussionmentioning

confidence: 99%

Comparison on efficacy of radical prostatectomy versus external beam radiotherapy for the treatment of localized prostate cancer

Chen

Wang

et al. 2017

Oncotarget

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Since there was no consensus on treatment options of localized prostate cancer, a meta-analysis was performed to compare the efficacy of radical prostatectomy (RP) versus external beam radiotherapy (EBRT) concluding three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiation therapy (IMRT). The search of eligible studies was performed on PubMed and Embase databases. The overall survival (OS), cancer-specific survival (CSS) and biochemical disease-free survival (BDFS) were compared by hazard ratio (HR) and odd ratios (OR). Twelve studies with 17137 patients were included. The pooled HR and 95% CI for OS, CSS and BDFS were 1.60 (1.44–1.79), 1.73 (1.34–2.24) and 0.65 (0.51–0.82), respectively. However, according to risk stratification, the HRs of CSS for low- to intermediate-risk patients were not significant. The 5-year and 10-year CSS reported significant OR and 95% CI of 1.96 (1.42–2.72) and 2.44 (1.33–4.48), except for 2-year CSS (P = 0.42). In conclusion, RP was generally associated with decreased risk of overall and cancer-specific mortality as well as better 5-year and 10-year OS and CSS. The EBRT was suggested to be a promising alternative option for low- to intermediate-risk patients. Large-scale prospective studies with risk stratification and adequate follow-up length were needed for further comprehensive comparison.

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Radical Prostatectomy versus External Beam Radiotherapy for cT1-4N0M0 Prostate Cancer: Comparison of Patient Outcomes Including Mortality

Cited by 14 publications

References 20 publications

An evaluation of response to therapy in patients undergoing radiotherapy or surgery in the treatment of prostate cancer

An evaluation of response to therapy in patients undergoing radiotherapy or surgery in the treatment of prostate cancer

Aggressive Cancer Behavior of Latent Gleason Pattern 5 in Prostatectomy Specimens

Comparison on efficacy of radical prostatectomy versus external beam radiotherapy for the treatment of localized prostate cancer

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