Outcomes of treatment for localized prostate cancer in a single institution: comparison of radical prostatectomy and radiation therapy by propensity score matching analysis | SpringerLink

Outcomes of treatment for localized prostate cancer in a single institution: comparison of radical prostatectomy and radiation therapy by propensity score matching analysis | SpringerLink: To compare the outcomes of radical prostatectomy (RP), intensity-modulated radiation therapy (IMRT), and low-dose-rate brachytherapy (BT) using propensity

Conclusion

The results of our propensity score analysis of mid-term localized prostate cancer treatment outcomes demonstrated no significant differences in the overall survival rate. Despite the difference in biochemical failure definition between surgery and radiotherapeutic approaches, the results of this study demonstrate improved biochemical control favoring IMRT and BT as compared to RP.
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Outcomes of treatment for localized prostate cancer in a single institution: comparison of radical prostatectomy and radiation therapy by propensity score matching analysis

Hiroji Uemura

11-13 minutes

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Abstract

Objectives

To compare the outcomes of radical prostatectomy (RP), intensity-modulated radiation therapy (IMRT), and low-dose-rate brachytherapy (BT) using propensity score matching analysis in patients with clinically localized prostate cancer.

Methods

A group of 2273 patients with clinically localized prostate cancer between January 2004 and December 2015 at the Yokohama City University hospital were identified. The records of 1817 of these patients, who were followed up for a minimum of 2 years, were reviewed; 462 were treated with RP, 319 with IMRT, and 1036 with BT. The patients were categorized according to the National Comprehensive Cancer Network risk classification criteria, and biochemical outcomes and overall survival rates were examined. Biochemical failure for RP was defined as prostate-specific antigen (PSA) levels > 0.2 ng/ml, and for IMRT and BT as nadir PSA level + 2 ng/ml. Propensity scores were calculated using multivariable logistic regression based on covariates, including the patient's age, preoperative PSA, Gleason score, number of positive cores, and clinical T stage.

Results

Median follow-up was 77 months for the RP, 54 months for IMRT, and 66 months for BT patients. After the propensity scores were adjusted, a total of 372 (186 each) and 598 (299 each) patients were categorized into RP vs IMRT and RP vs BT groups, respectively. Kaplan–Meier analysis did not show any statistically significant differences in terms of overall survival rate between these groups (RP vs IMRT: p = 0.220; RP vs BT: p = 0.429). IMRT was associated with improved biochemical failure-free survival compared to RP in all risk groups (high-risk: p < 0.001; intermediate-risk: p = 0.009; low-risk: p = 0.001), whereas significant differences were observed only in the intermediate-risk group (p = 0.003) within the RP vs BT group.

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References

1. 1.
   Ye D-W, Zhu Y, Wang H-K, Qu Y-Y (2015) Prostate cancer in East Asia: evolving trend over the last decade. Asian J Androl 17:48–57
2. 2.
   https://ganjohho.jp/reg_stat/statistics/stat/short_pred.html
3. 3.
   Wallis CJD et al (2016) Surgery versus radiotherapy for clinically-localized prostate cancer: a systematic review and meta-analysis. Eur Urol 70:21–30
4. 4.
   Hamdy FC et al (2016) 10-year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer. N Engl J Med 375:1415–1424
5. 5.
   Wilt TJ et al (2012) Radical prostatectomy versus observation for localized prostate cancer. N Engl J Med 367:203–213
6. 6.
   Bill-Axelson A et al (2011) Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med 364:1708–1717
7. 7.
   Hayashi N et al (2015) Ten-year outcomes of I(125) low-dose-rate brachytherapy for clinically localized prostate cancer: a single-institution experience in Japan. World J Urol 33(10):1519–1526
8. 8.
   Akakura K et al (2006) A randomized trial comparing radical prostatectomy plus endocrine therapy versus external beam radiotherapy plus endocrine therapy for locally advanced prostate cancer: results at median follow-up of 102 months. Jpn J Clin Oncol 36:789–793
9. 9.
   Paulson DF, Lin GH, Hinshaw W, Stephani S (1982) Radical surgery versus radiotherapy for adenocarcinoma of the prostate. J Urol 128:502–504
10. 10.
    Kibel AS et al (2012) Survival among men with clinically localized prostate cancer treated with radical prostatectomy or radiation therapy in the prostate specific antigen era. J Urol 187:1259–1265
11. 11.
    Donovan JL et al (2016) Patient-reported outcomes after monitoring, surgery, or radiotherapy for prostate cancer. N Engl J Med 375:1425–1437
12. 12.
    Spratt DE et al (2017) American Brachytherapy Society Task Group Report: combination of brachytherapy and external beam radiation for high-risk prostate cancer. Brachytherapy 16:1–12
13. 13.
    Cooperberg MR, Vickers AJ, Broering JM, Carroll PR (2010) Comparative risk-adjusted mortality outcomes after primary surgery, radiotherapy, or androgen-deprivation therapy for localized prostate cancer. Cancer 116:5226–5234
14. 14.
    Hoffman RM et al (2013) Mortality after radical prostatectomy or external beam radiotherapy for localized prostate cancer. J Natl Cancer Inst 105:711–718
15. 15.
    Nepple KG et al (2013) Mortality after prostate cancer treatment with radical prostatectomy, external-beam radiation therapy, or brachytherapy in men without comorbidity. Eur Urol 64:372–378
16. 16.
    Sooriakumaran P et al (2014) Comparative effectiveness of radical prostatectomy and radiotherapy in prostate cancer: observational study of mortality outcomes. BMJ 348:g1502
17. 17.
    Morris WJ et al (2017) Androgen Suppression Combined with Elective Nodal and Dose Escalated Radiation Therapy (the ASCENDE-RT Trial): an analysis of survival endpoints for a randomized trial comparing a low-dose-rate brachytherapy boost to a dose-escalated external beam boost. Int J Radiat Oncol Biol Phys 98:275–285
18. 18.
    Kishan AU et al (2016) Clinical outcomes for patients with Gleason score 9–10 prostate adenocarcinoma treated with radiotherapy or radical prostatectomy: a multi-institutional comparative analysis. Eur Urol 71(5):766–773
19. 19.
    Okamoto K, Wada A, Kohno N (2017) High biologically effective dose radiation therapy using brachytherapy in combination with external beam radiotherapy for high-risk prostate cancer. J Contemp Brachyther 9:1–6
20. 20.
    Kalbasi A et al (2015) Dose-escalated irradiation and overall survival in men with nonmetastatic prostate cancer. JAMA Oncol 1:897
21. 21.
    Zietman AL et al (2005) Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate. JAMA 294:1233
22. 22.
    Miki K et al (2010) Transperineal prostate brachytherapy, using I-125 seed with or without adjuvant androgen deprivation, in patients with intermediate-risk prostate cancer: study protocol for a phase III, multicenter, randomized, controlled trial. BMC Cancer 10:572
23. 23.
    Konaka H et al (2012) Tri-Modality therapy with I-125 brachytherapy, external beam radiation therapy, and short- or long-term hormone therapy for high-risk localized prostate cancer (TRIP): study protocol for a phase III, multicenter, randomized, controlled trial. BMC Cancer 12:110
24. 24.
    Saito S, Nagata H, Kosugi M, Toya K, Yorozu A (2007) Brachytherapy with permanent seed implantation. Int J Clin Oncol 12:395–407
25. 25.
    van Tol-Geerdink JJ et al (2013) Choice between prostatectomy and radiotherapy when men are eligible for both: a randomized controlled trial of usual care vs decision aid. BJU Int 111:564–573
26. 26.
    Koo KC et al (2017) Cancer-specific mortality among korean men with localized or locally advanced prostate cancer treated with radical prostatectomy versus radiotherapy: a multi-center study using propensity scoring and competing risk regression analyses. Cancer Res Treat 50(1):129–137

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Author information

Affiliations

1. Department of Urology, Yokohama City University, School of Medicine, Room A-625, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
   • Narihiko Hayashi
   • , Kimito Osaka
   • , Kentaro Muraoka
   • , Hisashi Hasumi
   • , Kazuhide Makiyama
   • , Keiichi Kondo
   • , Noboru Nakaigawa
   •  & Masahiro Yao
2. Department of Radiation Oncology, Yokohama City University, School of Medicine, Yokohama, Japan
   • Yuki Mukai
   • , Madoka Sugiura
   • , Shoko Takano
   • , Eiko Ito
   • , Hisashi Kaizu
   • , Izumi Koike
   •  & Masaharu Hata
3. Department of Biostatistics and Epidemiology, Yokohama City University, School of Medicine, Yokohama, Japan
   • Masataka Taguri
4. Department of Urology, Yokohama City University Medical Center, Yokohama, Japan
   • Yasuhide Miyoshi
   • , Koji Izumi
   • , Takashi Kawahara
   •  & Hiroji Uemura

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Contributions

Protocol/project development: NH, YM, and HU. Data collection or management: NH, KO, KM, HH, KM, KK, NN, MY, YM, MS, ST, EI, HK, IK, MH, YM, KI, TK, and HU. Data analysis: NH, YM, and MT. Manuscript writing/editing: NH.

Corresponding author

Correspondence to Narihiko Hayashi.

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Conflict of interest

Hiroji Uemura MD has financial interest and/or other relationship with Astellas, Janssen, Sanofi and Takeda. The authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable standards.

Informed consent

Informed consent prior to each treatment was obtained by every patient.

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Hayashi, N., Osaka, K., Muraoka, K. et al. Outcomes of treatment for localized prostate cancer in a single institution: comparison of radical prostatectomy and radiation therapy by propensity score matching analysis. World J Urol (2019) doi:10.1007/s00345-019-03056-3
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• Received10 September 2018
• Accepted01 February 2019
• Published24 December 2019
• DOIhttps://doi.org/10.1007/s00345-019-03056-3

Keywords

• Localized prostate cancer
• Prostatectomy
• Intensity-modulated radiation therapy
• Brachytherapy
• Propensity score matching analysis