PURPOSE: The purpose of this study was to evaluate long-term outcomes for men with early stage prostate cancer treated with radical prostatectomy (RP) or brachytherapy (BT) at a single tertiary care center.
METHODS AND MATERIALS: We retrospectively analyzed data from 371 men with clinical T1a-T2c disease with prostate-specific antigen level < 20ng/mL and Gleason score (GS) 6-7 who were treated with RP (n=279) or BT (n=92) at MD Anderson Cancer Center in 2000-2001. Biochemical recurrence-free survival (BRFS) and prostate cancer-specific survival rates were compared by treatment modality.
RESULTS: The median followup time was 7.2 and 7.6 years for patients treated with RP and BT, respectively. Disease was upgraded from GS 6 to 7 after central review of the biopsy specimen for 36 men treated with RP (12.9%) and 15 men treated with BT (16.3%). After RP, GS was upgraded in 121 men (43.4%) between the centrally reviewed biopsy and the RP specimen. After RP, 5-year BRFS rates were 96.1% and 90.6% for low- and intermediate-risk disease, respectively (p=0.003). After BT, 5-year BRFS rates were 92.5% and 95.8% for low- and intermediate-risk disease, respectively (p=0.017). After RP or BT, 5-year BRFS rates were not significantly different with GS upgraded. Five-year prostate cancer-specific survival rates for patients with upgraded GS were 100% for both RP and BT.
CONCLUSIONS: Excellent disease control outcomes can be achieved after either RP or BT as monotherapy for men with early stage prostate cancer. Upgrading of GS from 6 to 7, either (3+4) or (4+3), did not predict for worse outcomes.
Written by:
Fisher CM, Troncoso P, Swanson DA, Munsell MF, Kuban DA, Lee AK, Yeh SF, Frank SJ. Are you the author?
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Reference: Brachytherapy. 2012 Jun 21. Epub ahead of print.
doi: 10.1016/j.brachy.2012.04.009
PubMed Abstract
PMID: 22727472
UroToday.com Prostate Cancer Section