Ten-years outcome analysis in patients with clinically localized prostate cancer treated by radical prostatectomy or external beam radiation therapy

Shu-Wen Li; Allen W Chiu; Andy C Huang; Yu-Wei Lai; Jyh-Der Leu; Yi-Chun Hsiao; Shiou-Sheng Chen; Thomas Y Hsueh

doi:10.3389/fsurg.2022.966025

Ten-years outcome analysis in patients with clinically localized prostate cancer treated by radical prostatectomy or external beam radiation therapy

Front Surg. 2022 Jul 29:9:966025. doi: 10.3389/fsurg.2022.966025. eCollection 2022.

Authors

Shu-Wen Li¹, Allen W Chiu^{1

2

3}, Andy C Huang^{1

2}, Yu-Wei Lai^{1

2}, Jyh-Der Leu⁴, Yi-Chun Hsiao¹, Shiou-Sheng Chen^{2

5}, Thomas Y Hsueh^{1

2}

Affiliations

¹ Division of Urology, Department of Surgery, Taipei City Hospital renai Branch, Taipei, Taiwan.
² Department of Urology, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.
³ Division of Urology, Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
⁴ Division of Radiation Oncology, Taipei City Hospital Renai Branch, Taipei, Taiwan.
⁵ Division of Urology, Department of Surgery, Taipei City Hospital Zhongxiao Branch, Taipei, Taiwan.

Abstract

Purpose: Since there was no consensus on treatment options for localized prostate cancer, we performed a retrospective study to compare the long-term survival benefit of radiotherapy (RT) versus laparoscopic radical prostatectomy (LRP) in Taiwan.

Methods: 218 patients with clinically localized prostate cancer treated between 2008 and 2017 (64 with LRP and 154 with RT) were enrolled in this study. The outcomes of RT and LRP were assessed after patients were stratified according to Gleason score, stage, and risk group. Crude survival, prostate cancer-specific survival, and metastasis-free survival were evaluated using the log-rank test.

Results: The 5-year crude survival rate was 93.3% in the LRP group and 59.3% in the RT group. A significant survival benefit was found in the LRP group compared with the RT group (p = 0.004). Furthermore, significant differences were found in disease-specific survival (93.3% vs. 64.7%, p = 0.022) and metastasis-free survival (48% vs. 40.2%, p = 0.045) between the LRP and RT groups.

Conclusions: Men with localized prostate cancer treated initially with LRP had a lower risk of prostate cancer-specific death and metastases compared with those treated with RT.

Keywords: intensity modulated radiotherapy; laparoscopic radical prostatectomy; localized prostate cancer (PCa); metastasis-free survival (MFS); prostate cancer-specific survival.