Prostate cancer (PCa) is the most common non-dermatologic cancer in the western countries in western countries.
High-risk PCa accounts for 15% of the diagnosed cases. In this study, we compare the long-term survival outcomes of radical prostatectomy (RP), radiation therapy (RT), brachytherapy (BT), androgen- deprivation therapy (ADT), and watchful waiting (WW) in high-risk prostate cancer (PCa). Overall, RP/(RT plus ADT) gave the best survival outcome in patients with high-risk PCa, whereas ADT/WW had the worst outcome. The overall priority for treatment strategy could be ranked as follows: RP/(RT plus ADT), RT, and ADT/WW. RP had significant better overall survival (OS) than RT or BT, and RP had significant lower cancer-specific mortality (CSM) than RT (0.51 [95% CI 0.30-0.73], P< 0.001). ADT improved the cancer-specific survival (CSS) of RP based on a case-controlled study; added ADT to RT failed to challenge the position of RP but could improve the outcome of RT. In conclusions,RP/(RT plus adjuvant ADT) could both be used for the first-line therapy of high-risk PCa. When encountering an individual patient, urologists should consider various factors like tumors themselves, preferences of individuals, and so on.
Written by:
Lei JH, Liu LR, Wei Q, Yan SB, Song TR, Lin FS, Yang L, Cao de H, Yuan HC, Xue WB, Lv X, Cai YC, Zeng H, Han P. Are you the author?
Department of Urology, West China Hospital, Sichuan University, Chengdu, China; Department of Urology, Dujiangyan Medical Center/the affiliated hospital of Chengdu University, Dujianyan, China.
Reference: Sci Rep. 2015 Jan 12;5:7713.
doi: 10.1038/srep07713
PubMed Abstract
PMID: 25578739