Comparison of radical prostatectomy and external beam radiotherapy in high-risk prostate cancer

Radiation Oncology Journal 2021³â 39±Ç 3È£ p.231 ~ p.238

Àü¼®ÁÖ(Chun Seok-Joo) - Seoul National University College of Medicine Department of Radiation Oncology
±èÁøÈ£(Kim Jin-Ho) - Seoul National University College of Medicine Department of Radiation Oncology
±¸ÀÚÇö(Ku Ja-Hyeon) - Seoul National University College of Medicine Department of Urology
°ûö(Kwak Cheol) - Seoul National University College of Medicine Department of Urology
ÀÌÀº½Ä(Lee Eun-Sik) - Seoul National University College of Medicine Department of Urology
±è¼öÁö(Kim Su-Zy) - Seoul National University College of Medicine Department of Radiation Oncology

Abstract

Purpose: We evaluated clinical outcomes of high-risk prostate cancer patients receiving external beam radiotherapy (EBRT) or radical prostatectomy (RP).

Materials and Methods: Patients were classified as high-risk prostate cancer and received definitive treatment between 2005 and 2015. Patients with previous pelvic radiotherapy, positive lymph node or distant metastasis were excluded. The primary outcomes were prostate cancer-specific survival (PCSS) and distant metastasis-free survival (DMFS).

Results: Of 583 patients met the inclusion criteria (77 EBRT and 506 RP), the estimated 10-year PCSS was 97.0% in the RP and 95.9% in the EBRT (p = 0.770). No significant difference was seen in the DMFS (p = 0.540), whereas there was a trend in favor of RP over EBRT in overall survival (OS) (p = 0.068). Propensity score matching analysis with confounding variables was done, with 183 patients (66 EBRT and 117 RP) were included. No significant difference in DMFS, PCSS or OS was found.

Conclusion: Our data demonstrated similar oncologic PCSS, OS, and DMFS outcomes between EBRT and RP patients.

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Radiotherapy, Prostatectomy, Prostatic neoplasms
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