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Intensity-modulated radiotherapy versus radical prostatectomy in patients with localized prostate cancer: long-term follow-up

BACKGROUND: The objective of this work was to assess the overall survival, cause-specific survival and biochemical failure-free survival of a contemporary cohort of patients with localized prostate cancer (PCa) treated with intensity-modulated radiation therapy (IMRT) or radical prostatectomy (RP)....

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Autores principales: Merino, Tomás, San Francisco, Ignacio F, Rojas, Pablo A, Bettoli, Piero, Zúñiga, Álvaro, Besa, Pelayo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833713/
https://www.ncbi.nlm.nih.gov/pubmed/24209381
http://dx.doi.org/10.1186/1471-2407-13-530
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author Merino, Tomás
San Francisco, Ignacio F
Rojas, Pablo A
Bettoli, Piero
Zúñiga, Álvaro
Besa, Pelayo
author_facet Merino, Tomás
San Francisco, Ignacio F
Rojas, Pablo A
Bettoli, Piero
Zúñiga, Álvaro
Besa, Pelayo
author_sort Merino, Tomás
collection PubMed
description BACKGROUND: The objective of this work was to assess the overall survival, cause-specific survival and biochemical failure-free survival of a contemporary cohort of patients with localized prostate cancer (PCa) treated with intensity-modulated radiation therapy (IMRT) or radical prostatectomy (RP). METHODS: We did a retrospective cohort study of our institution’s registry of patients undergoing either IMRT or RP between January 1999 and March 2010, and assessed Prostate Specific Antigen (PSA), age at diagnosis, Gleason score, and digital rectal examination. Two groups were separated according to RP or IMRT treatment and these groups were in turn divided into risk groups according to the D’Amico classification. Overall survival (OS), cause-specific survival (CSS), mortality from other causes (MOC), and biochemical disease-free survival (BDFS) were assessed. RESULTS: Twelve-hundred patients were included: 993 in the RP group and 207 in the IMRT group. The IMRT group had older age, PSA at diagnosis and a significantly higher percentage of cancer on the needle biopsy (p <0.001). Of the 207 patients who underwent IMRT, 54% presented comorbidities. Median follow-up was 91.7 months for the RP group and 76 months for the IMRT group. The OS at 5 and 7 was 96.2, and 93.7 for the RP group respectively and 88.4, and 83.1 for the IMRT group respectively (p <0.001). There were no significant differences in the CSS in relation to treatment received among the low- and high-risk groups, while in the intermediate-risk group, patients who underwent to RP had a higher CSS than patients who underwent IMRT (99.6% vs 94.1%, p = 0.003). The IMRT group had a significantly better BDFS than the RP group (86.4% vs. 74.3%, respectively, p = 0.016). CONCLUSIONS: Patients treated with RP were significantly younger and had a better prognosis than patients treated using IMRT, and according to our results, RP had better outcomes in terms of OS while IMRT had greater MOC. Treatment modality did not affect the CSS.
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spelling pubmed-38337132013-11-20 Intensity-modulated radiotherapy versus radical prostatectomy in patients with localized prostate cancer: long-term follow-up Merino, Tomás San Francisco, Ignacio F Rojas, Pablo A Bettoli, Piero Zúñiga, Álvaro Besa, Pelayo BMC Cancer Research Article BACKGROUND: The objective of this work was to assess the overall survival, cause-specific survival and biochemical failure-free survival of a contemporary cohort of patients with localized prostate cancer (PCa) treated with intensity-modulated radiation therapy (IMRT) or radical prostatectomy (RP). METHODS: We did a retrospective cohort study of our institution’s registry of patients undergoing either IMRT or RP between January 1999 and March 2010, and assessed Prostate Specific Antigen (PSA), age at diagnosis, Gleason score, and digital rectal examination. Two groups were separated according to RP or IMRT treatment and these groups were in turn divided into risk groups according to the D’Amico classification. Overall survival (OS), cause-specific survival (CSS), mortality from other causes (MOC), and biochemical disease-free survival (BDFS) were assessed. RESULTS: Twelve-hundred patients were included: 993 in the RP group and 207 in the IMRT group. The IMRT group had older age, PSA at diagnosis and a significantly higher percentage of cancer on the needle biopsy (p <0.001). Of the 207 patients who underwent IMRT, 54% presented comorbidities. Median follow-up was 91.7 months for the RP group and 76 months for the IMRT group. The OS at 5 and 7 was 96.2, and 93.7 for the RP group respectively and 88.4, and 83.1 for the IMRT group respectively (p <0.001). There were no significant differences in the CSS in relation to treatment received among the low- and high-risk groups, while in the intermediate-risk group, patients who underwent to RP had a higher CSS than patients who underwent IMRT (99.6% vs 94.1%, p = 0.003). The IMRT group had a significantly better BDFS than the RP group (86.4% vs. 74.3%, respectively, p = 0.016). CONCLUSIONS: Patients treated with RP were significantly younger and had a better prognosis than patients treated using IMRT, and according to our results, RP had better outcomes in terms of OS while IMRT had greater MOC. Treatment modality did not affect the CSS. BioMed Central 2013-11-08 /pmc/articles/PMC3833713/ /pubmed/24209381 http://dx.doi.org/10.1186/1471-2407-13-530 Text en Copyright © 2013 Merino et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Merino, Tomás
San Francisco, Ignacio F
Rojas, Pablo A
Bettoli, Piero
Zúñiga, Álvaro
Besa, Pelayo
Intensity-modulated radiotherapy versus radical prostatectomy in patients with localized prostate cancer: long-term follow-up
title Intensity-modulated radiotherapy versus radical prostatectomy in patients with localized prostate cancer: long-term follow-up
title_full Intensity-modulated radiotherapy versus radical prostatectomy in patients with localized prostate cancer: long-term follow-up
title_fullStr Intensity-modulated radiotherapy versus radical prostatectomy in patients with localized prostate cancer: long-term follow-up
title_full_unstemmed Intensity-modulated radiotherapy versus radical prostatectomy in patients with localized prostate cancer: long-term follow-up
title_short Intensity-modulated radiotherapy versus radical prostatectomy in patients with localized prostate cancer: long-term follow-up
title_sort intensity-modulated radiotherapy versus radical prostatectomy in patients with localized prostate cancer: long-term follow-up
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833713/
https://www.ncbi.nlm.nih.gov/pubmed/24209381
http://dx.doi.org/10.1186/1471-2407-13-530
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