BACKGROUND: This study was designed to compare the long-term oncological outcome of patients with clinical T3 (cT3) prostate cancer (PCA) treated with either radical prostatectomy (RP) or external-beam radiation therapy (EBRT) and to identify predictors of oncological outcomes.
METHODS: A total of 231 patients with cT3 PCA underwent either RP (n = 112) or EBRT (n = 119). Local progression-free (LPFS), distant metastasis-free (DMFS), cancer-specific (CSS), and overall survival curves were generated with the Kaplan-Meier method, and the differences in survival rates between the two groups were assessed with a log-rank test. Cox proportional stepwise multivariate analysis was used to assess the association of variables to the oncological outcomes.
RESULTS: The median follow-up of the RP and EBRT groups was 93 and 85 months, respectively (p = 0.004).The 10-year LPFS, DMFS, and CSS rates were not statistically different between the two groups (90.2, 73.9, and 93.7 % in the RP group and 82.7, 88.2, and 85.1 % in the EBRT group; p = 0.25, 0.10, and 0.10, respectively). The Cox proportional multivariate analysis revealed that clinical T3b (cT3b) (p = 0.001) and a biopsy Gleason score of 7-10 (p = 0.043) were significant predictors of cancer-specific mortality and that cT3b was also a significant predictor of local progression and all-cause mortality.
CONCLUSION: In cT3 PCA, both RP and EBRT provide an excellent long-term oncological outcome. cT3b was the strongest predictor of oncological outcome for the patients with locally advanced PCA who underwent the definitive therapy.
Written by:
Yamamoto S, Kawakami S, Yonese J, Fujii Y, Urakami S, Kitsukawa S, Masuda H, Ishikawa Y, Kozuka T, Oguchi M, Kohno A, Fukui I Are you the author?
Department of Urology, Japanese Foundation for Cancer Research, Cancer Institute Hospital, 3-8-31 Ariake, Koto, Tokyo, 135-8550, Japan,
Reference: Int J Clin Oncol. 2013 Dec 19. (Epub ahead of print)
doi: 10.1007/s10147-013-0654-2
PubMed Abstract
PMID: 24346487
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