Evaluation of biochemical recurrence in patients with high-risk prostate cancer treated with radical prostatectomy and radiotherapy plus androgen deprivation therapy
Authors Yamamoto Y, Kiba K, Yoshikawa M, Hirayama A, Kunikata S, Uemura H
Received 26 August 2016
Accepted for publication 4 November 2016
Published 2 December 2016 Volume 2016:8 Pages 225—231
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Jan Colli
Yutaka Yamamoto,1 Keisuke Kiba,1 Motokiyo Yoshikawa,1 Akihide Hirayama,1 Seiji Kunikata,1 Hirotsugu Uemura2
1Department of Urology, Nara Hospital, Kindai University Faculty of Medicine, Ikoma, 2Department of Urology, Kindai University Faculty of Medicine, Osakasayama, Japan
Objective: The aim of this study was to evaluate the biochemical recurrence (BCR) in patients with high-risk prostate cancer (PCa) treated with radical prostatectomy (RP) or radiotherapy (RT) plus androgen deprivation therapy (ADT).
Methods: Subjects were patients with National Comprehensive Cancer Network-defined high-risk PCa treated with either RP or RT plus ADT. We calculated BCR-free survival in patients with those treatments and evaluated risk factor against BCR.
Results: A total of 114 patients, 71 RP and 43 RT plus ADT, were evaluated. A total of 59 and 20.9% of patients experienced BCR in the RP and RT treatment groups, respectively. The 5-year BCR-free survival probabilities improved significantly for patients who received RT compared to those who received RP (81.3 vs 37.3%, P<0.001). According to the number of risk factors, 59.2% of patients in the RP and 51.2% of patients in the RT treatment groups were classified with one risk factor (P<0.014). The 5-year BCR-free survival probabilities for patients treated with RP were 46.6 and 21.7% for one and multiple risk factors, respectively (P=0.008). On univariate analysis, only the number of risk factors had a significant impact on the risk of BCR. Meanwhile, there were no significant differences in the 5-year BCR-free survival probabilities between one and multiple risk factors in patients treated with RT.
Conclusion: Among patients treated with RP, a marked heterogeneity existed in the oncological outcomes. Based on these findings, the number of risk factors should be emphasized to decide the optimal treatments for patients with high-risk PCa.
Keywords: high-risk prostate cancer, radical prostatectomy, radiotherapy plus androgen deprivation therapy, biochemical recurrence, number of risk factors
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