Tag: Prostate cancer

Comparative evaluation of radiation treatments for clinically localized prostate cancer: an update


Source: Centers of Medicare

Table 1. Side-effects and effects on recovery ...
Table 1. Side-effects and effects on recovery of treatments for newly diagnosed prostate cancer. The Prostate Brachytherapy Advisory Group: http://www.prostatebrachytherapyinfo.net (Photo credit: Wikipedia)

With the advent of the prostate-specific antigen (PSA) test in the 1990s, the lifetime risk of being diagnosed with prostate cancer in the United States has nearly doubled to twenty percent.  However, the risk of dying of prostate cancer remains at approximately three percent.  Once prostate cancer has been diagnosed, the decision on the best course of treatment can be complex.  Numerous factors can influence the decision on how to proceed, including that some prostate cancers grow so slowly they would likely never cause significant problems during a patient’s lifetime.  The adverse effects of the available interventions and how they affect quality of life must also be considered.

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Radical Prostatectomy or Radiotherapy in High-Risk Prostate Cancer


Clin Genitourin Cancer. 2014 Feb 6. pii: S1558-7673(14)00018-4. doi: 10.1016/j.clgc.2014.01.010. [Epub ahead of print]

Radical Prostatectomy or Radiotherapy in High-Risk Prostate Cancer: A Systematic Review and Metaanalysis.

Petrelli F1, Vavassori I2, Coinu A3, Borgonovo K3, Sarti E4, Barni S3.

English: Micrograph of prostatic adenocarcinom...
English: Micrograph of prostatic adenocarcinoma, conventional (acinar) type, the most common form of prostate cancer. Prostate biopsy. H&E stain. (Photo credit: Wikipedia)

Author information

  • 1Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Bergamo, Italy. Electronic address: faupe@libero.it.
  • 2Surgical Department, Urology Unit, Azienda Ospedaliera Treviglio, Treviglio, Bergamo, Italy.
  • 3Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Bergamo, Italy.
  • 4Oncology Department, Radiotherapy Unit, Azienda Ospedaliera Treviglio, Treviglio, Bergamo, Italy.

Abstract

BACKGROUND:

Radical prostatectomy (RP) is one of the treatment options for localized, high-risk prostate cancer (PC), but it has never been compared with external beam radiotherapy (RT), which is an alternative approach, in a large randomized trial. To compare the outcomes of patients treated with surgery versus RT, we performed a metaanalysis of available studies on this topic.

MATERIALS AND METHODS:

We performed a search of MEDLINE, EMBASE, Web of Science, SCOPUS, and The Cochrane Central Register of Controlled Trials (CENTRAL) for randomized or observational studies that investigated overall survival (OS) and PC-specific mortality (PCSM) risks in relation to use of surgery or RT in patients with high-risk PC. Fixed- and random-effect models were fitted to estimate the summary odds ratio (OR). Between-study heterogeneity was tested using χ2 statistics and measured using the I2 statistic. Publication bias was evaluated using a funnel plot and Egger regression asymmetry test.

RESULTS:

Seventeen studies were included (1 randomized and 16 retrospective). RP was associated with improved OS (OR, 0.51; 95% confidence interval [CI], 0.38-0.68; P < .00001), PCSM (OR, 0.56; 95% CI, 0.37-0.85; P = .007), and non-PCSM (OR, 0.53; 95% CI, 0.35-0.8; P = .002) compared with RT. Biochemical relapse-free survival rates were similar to those of RT.

CONCLUSION:

Overall and cancer-specific mortality rates appear to be better with RP compared with RT in localized, high-risk PC. Surgery is also associated with a 50% decreased risk of non-PCSM compared with RT.Cancer mortality; Overall survival; Prostate carcinoma; Radiation therapy; Surgery

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