Abstract
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 <20. ng/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.
Original language | English (US) |
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Pages (from-to) | 429-434 |
Number of pages | 6 |
Journal | Brachytherapy |
Volume | 11 |
Issue number | 6 |
DOIs | |
State | Published - Nov 2012 |
Keywords
- Comparative effectiveness
- Gleason score
- Interstitial implant
- LDR brachytherapy
- Prostate biopsy
- Prostate cancer
- Prostate surgery
- Seeds
ASJC Scopus subject areas
- Oncology
- Radiology Nuclear Medicine and imaging
MD Anderson CCSG core facilities
- Biostatistics Resource Group