Survival Outcomes Among Men with Clinically Localized Prostate Cancer Treated with Radical Prostatectomy, Brachytherapy, Cryosurgical Ablation and Intensity-modulated Radiotherapy: A Single Surgeon Local Experience

Survival Outcomes Among Men with Clinically Localized Prostate Cancer Treated with Radical Prostatectomy, Brachytherapy, Cryosurgical Ablation and Intensity-modulated Radiotherapy: A Single Surgeon Local Experience
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Title:Survival Outcomes Among Men with Clinically Localized Prostate Cancer Treated with Radical Prostatectomy, Brachytherapy, Cryosurgical Ablation and Intensity-modulated Radiotherapy: A Single Surgeon Local Experience
Author/Abstract:

Marlon P. Martinez MD and Jason L. Letran, MD, FPUA
Section of Urology, Department of Surgery, University of Santo Tomas Hospital

Objective: Radical prostatectomy (RP), brachytherapy, cryosurgical ablation and intensity-modulated radiotherapy (IMRT) are accepted
treatment options for localized prostate cancer. The objectives of this study were to determine the overall survival (OS), disease specific
survival (DSS) and biochemical no evidence of disease (BNED) rates of the patients who underwent these different treatment modalities.

Materials and Methods: A total of 485 patients with localized prostate cancer treated with RP (n=235), brachytherapy (n=202), cryosurgical
ablation (n=33), and IMRT (n=15) were identified from the database of a single urological practice. Analysis of variance (ANOVA) was used
to compare means of patients. Chi-square test was used to compare percentages. Kaplan-Meier survival analysis was used to determine if the
outcome parameters significantly differed according to the methods. Pvalues less than 0.05 indicate significant difference. All the
statistical tests were performed using SPSS 20.0.

Results: The OS rate after RP, brachytherapy, cryosurgical ablation and IMRT were 97.9%, 89.1%, 93.9% and 93.3%, respectively. The DSS rate
was 99.6%, 98.0% and 97.0%. respectively. No mortality from prostatic cause was reported from IMRT. The BNED rate was 90.6%, 88.1%, 78.8%
and 93.3%, respectively.

Conclusion: The overall and disease specific survival were comparable among all treatment modalities. Although radical prostatectomy and
IMRT showed an overall better BNED outcomes, this advantage disappeared when the patients were analyzed according to their respective risk
stratification into low, moderate and high risk group.

Key words: localized prostate cancer, treatment options, survival

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