Mortality and biochemical recurrence after surgery, brachytherapy, or external radiotherapy for localized prostate cancer: a 10-year follow-up cohort study

To compare the effectiveness at ten years of follow-up of radical prostatectomy, brachytherapy and external radiotherapy, in terms of overall survival, prostate cancer-specific mortality and biochemical recurrence. Cohort of men diagnosed with localized prostate cancer (T1/T2 and low/intermediate ri...

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Detalhes bibliográficos
Autores: Suárez-Novo, José Francisco, Zamora, Víctor, Garín, Olatz, Hervás, Asunción, Ponce de León, Javier, Guedea, Ferran, Vigués, Francesc, Castells, Manuel, Ferrer Santanach, Montserrat, Pont, Àngels, Pardo, Yolanda, Alonso Caballero, Jordi, Ventura i Oller, Montserrat, Gutiérrez, Cristina, Ferrer, Ferran, Boladeras, Ana, Bonet Felipe, Xavier, Ávila, Mónica, Pastor, Sergi, Bonet, Carmen, Sancho, Gemma, Palou, Joan, Paula, Belen de, Goñi, Alai, Fernández, Pablo, 1957-, Herruzo, Ismael, Ramos, Alfredo, 1951-, Macías, Víctor, Solé, Josep, Bonet, Marta, Mariño, Alfonso, Cabrera, Patricia, Ortiz, María José, Multicentric Spanish Group Of Clinically Localized Prostate Cancer
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Recursos:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/188945
Acesso em linha:https://hdl.handle.net/2445/188945
Access Level:acceso abierto
Palavra-chave:Assaigs clínics
Càncer de pròstata
Cirugía de la próstata
Radioteràpia
Clinical trials
Prostate cancer
Prostate surgery
Radiotherapy
Descrição
Resumo:To compare the effectiveness at ten years of follow-up of radical prostatectomy, brachytherapy and external radiotherapy, in terms of overall survival, prostate cancer-specific mortality and biochemical recurrence. Cohort of men diagnosed with localized prostate cancer (T1/T2 and low/intermediate risk) from ten Spanish hospitals, followed for 10 years. The treatment selection was decided jointly by patients and physicians. Of 704 participants, 192 were treated with open radical retropubic prostatectomy, 317 with I-125 brachytherapy alone, and 195 with 3D external beam radiation. We evaluated overall survival, prostate cancer-specific mortality, and biochemical recurrence. Kaplan-Meier estimators were plotted, and Cox proportional-hazards regression models were constructed to estimate hazard ratios (HR), adjusted by propensity scores. Of the 704 participants, 542 patients were alive ten years after treatment, and a total of 13 patients have been lost during follow-up. After adjusting by propensity score and Gleason score, brachytherapy and external radiotherapy were not associated with decreased 10-year overall survival (aHR = 1.36, p = 0.292 and aHR = 1.44, p = 0.222), but presented higher biochemical recurrence (aHR = 1.93, p = 0.004 and aHR = 2.56, p < 0.001) than radical prostatectomy at ten years of follow-up. Higher prostate cancer-specific mortality was also observed in external radiotherapy (aHR = 9.37, p = 0.015). Novel long-term results are provided on the effectiveness of brachytherapy to control localized prostate cancer ten years after treatment, compared to radical prostatectomy and external radiotherapy, presenting high overall survival, similarly to radical prostatectomy, but higher risk of biochemical progression. These findings provide valuable information to facilitate shared clinical decision-making.

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