The treatment of choice for localized poorly differentiated adenocarcinoma of the prostate

Of 286 evaluable patients definitively irradiated for adenocarcinoma of the prostate, 71 with Stage B₂ and C poorly differentiated lesions were studied. Forty-six patients were treated with external beam therapy and 25 with ¹²⁵I implantation and pelvic lymph node dissection. Within both the external beam and the ¹²⁵I treatment groups, the local recurrence rate was noticeably higher in the Stage C than in the Stage B₂ tumors. Moreover, the incidence of local failure was significantly increased in those patients treated with ¹²⁵I implantation, 56% vs. 24% (p = 0.008), suggesting that external beam irradiation may be the treatment of choice for localized, poorly differentiated prostatic tumors.