RT Journal Article
T1 Mortality and biochemical recurrence after surgery, brachytherapy, or external radiotherapy for localized prostate cancer: a 10-year follow-up cohort study.
A1 Suarez, Jose Francisco
A1 Zamora, Victor
A1 Garin, Olatz
A1 Gutierrez, Cristina
A1 Pont, Angels
A1 Pardo, Yolanda
A1 Goñi, Alai
A1 Mariño, Alfonso
A1 Hervas, Asuncion
A1 Herruzo, Ismael
A1 Cabrera, Patricia
A1 Sancho, Gemma
A1 Ponce de Leon, Javier
A1 Macias, Victor
A1 Guedea, Ferran
A1 Vigues, Francesc
A1 Castells, Manuel
A1 Ferrer, Montse
K1 Prostate-Specific Antigen
K1 Prostatectomy
K1 Prostatic Neoplasms
AB 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 125I 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 on the effectiveness of brachytherapy to control localized prostate cancer ten years after treatment, compared to radical prostatectomy and external radiotherapy, showed high overall survival, similar to radical prostatectomy, but with a higher risk of biochemical progression. These findings provide valuable information to facilitate shared clinical decision-making.
PB Nature Publishing Group
YR 2022
FD 2022-07-22
LK http://hdl.handle.net/10668/19618
UL http://hdl.handle.net/10668/19618
LA en
NO Suárez JF, Zamora V, Garin O, Gutiérrez C, Pont À, Pardo Y, et al. Mortality and biochemical recurrence after surgery, brachytherapy, or external radiotherapy for localized prostate cancer: a 10-year follow-up cohort study. Sci Rep. 2022 Jul 22;12(1):12589
NO T he study was funded through competitive grants from the Instituto de Salud Carlos III FEDER: Fondo Europeo de Desarrollo Regional (Grant numbers PI02/0668, PI08/90090, PI13/00412, PI21/00023, and FI19/00229); Generalitat de Catalunya, Spain (Grant numbers 086/24/2000 and 2017 SGR 452); and CIBER de Epidemiología y Salud Pública CIBERESP (research funding CB06/02/0046).
DS RISalud
RD Apr 7, 2025