The Korean Journal of Urological Oncology (대한비뇨기종양학회지)

Korean Urological Oncology Society (대한비뇨기종양학회)
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Prostatectomy Provides Better Symptom-Free Survival Than Radiotherapy Among Patients With High-Risk or Locally Advanced Prostate Cancer After Neoadjuvant Hormonal Therapy

  • Kim, Sung Han (Department of Urology, Center for Prostate Cancer, National Cancer Center Hospital) ;
  • Song, Mi Kyung (Biometrics Research Branch and Biostatistics Collaboration Unit, National Cancer Center Hospital) ;
  • Park, Weon Seo (Department of Pathology, Center for Prostate Cancer, National Cancer Center Hospital) ;
  • Joung, Jae Young (Department of Urology, Center for Prostate Cancer, National Cancer Center Hospital) ;
  • Seo, Ho Kyung (Department of Urology, Center for Prostate Cancer, National Cancer Center Hospital) ;
  • Chung, Jinsoo (Department of Urology, Center for Prostate Cancer, National Cancer Center Hospital) ;
  • Lee, Kang Hyun (Department of Urology, Center for Prostate Cancer, National Cancer Center Hospital)
  • Received : 2018.11.01
  • Accepted : 2018.12.07
  • Published : 2018.12.30
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Abstract

Purpose: The purpose of this study is to compare the radiation therapy (RT) and radical prostatectomy (RP) of high-risk or locally advanced prostate cancer (PC) patients after neoadjuvant hormonal therapy (NHT). Materials and Methods: This retrospective study evaluated patients underwent RT (42 patients) or RP (152 patients) after NHT at a single center during 2003-2014. Times to biochemical recurrence (BCR), pelvic local recurrence (PLR), metastasis, clinical painful symptom progression (CPSP), castration-resistant PC (CRPC), and overall survival were compared between the RT and RP groups, after adjustment for TN stage, using the Kaplan-Meier method and log-rank test. Results: Significant inter-group differences were observed for age, Gleason score, initial PSA, and clinical and pathological T stages (all p<0.05). During a median follow-up of 71.7 months, the overall incidences of BCR, PLR, metastasis, CPSP, CRPC, and death were 49.5%, 16.5%, 8.3%, 7.7%, 7.7%, and 17.5%, respectively. The median times to BCR were 100 months for RT and 36.2 months for RP (p=0.004), although the median times were not reached for the other outcomes (all p>0.05). The independent predictor of CPSP was RP (hazard ratio, 0.291; p=0.013). Conclusions: Despite significantly different baseline parameters, RP provided better CPSP-free survival than RT among patients with localized high-risk or locally advanced PC.

Keywords

Acknowledgement

Supported by : Korean National Cancer Center

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