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.
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.
Authors: Paolo Emiliozzi; Paolo Scarpone; Francesco DePaula; Maurizio Pizzo; Giorgio Federico; Alberto Pansadoro; Marco Martini; Vito Pansadoro Journal: J Urol Date: 2004-01 Impact factor: 7.450
Authors: Christopher R King; John E McNeal; Harcharan Gill; Joseph C Presti Journal: Int J Radiat Oncol Biol Phys Date: 2004-06-01 Impact factor: 7.038
Authors: Patrick A Kupelian; Louis Potters; Deepak Khuntia; Jay P Ciezki; Chandana A Reddy; Alwyn M Reuther; Thomas P Carlson; Eric A Klein Journal: Int J Radiat Oncol Biol Phys Date: 2004-01-01 Impact factor: 7.038