Radical Prostatectomy Versus Radiotherapy for Localized Ductal Prostate Cancer
Posted: Friday, February 5, 2021
Radical prostatectomy and external-beam radiation therapy with or without brachytherapy may yield similar survival benefits for patients with localized ductal adenocarcinoma of the prostate, according to Mohummad Minhaj Siddiqui, MD, of the University of Maryland School of Medicine, Baltimore, and colleagues. The results of this analysis were presented during the virtual edition of the 2020 Society of Urologic Oncology (SUO) Annual Meeting (Abstract 182).
Using data from the Surveillance, Epidemiology, and End Results database from 2004 through 2016, the investigators identified patients who underwent radical prostatectomy (n = 120) or external-beam radiation therapy with or without brachytherapy (n = 39). Logistic regression analyses revealed that patients older than age 75 (odds ratio = 0.085; P < .001) and those with a prostate-specific antigen (PSA) level greater than 20 ng/mL (odds ratio = 0.146; P = .008) seemed to be less likely to undergo radical prostatectomy.
At 5 years, the overall survival rate was 94.2% in patients who underwent radical prostatectomy and 92.3% in those who received external-beam radiation therapy with or without brachytherapy (P = .708); the rates of disease-specific survival were 96.7% and 92.3%, respectively (P = .364). Based on Kaplan-Meier curve analyses, patients appeared to achieve similar overall and disease-specific survival outcomes with radical prostatectomy and external-beam radiation therapy with or without brachytherapy (all P > .05).
Cox regression analyses demonstrated that Gleason Scores of 9 (hazard ratio = 4.117; P = .004) or 10 (hazard ratio = 20.283; P = .011) as well as PSA levels between 10 and 20 ng/mL (hazard ratio = 4.219; P = .022) seemed to be independently associated with worse survival. After the investigators controlled for age, year of diagnosis, race, and marital status, radical prostatectomy did not appear to be independently associated with survival (hazard ratio = 1.049; P = .936).
Disclosure: No information regarding conflicts of interest was provided.