The Prognosis of Radical Prostatectomy, External Beam Radiotherapy plus Brachytherapy, and External Beam Radiotherapy Alone for Patients above 70 Years with Very High-Risk Prostate Cancer: A Population-Matched Study.
Urol Int
; 106(1): 11-19, 2022.
Article
em En
| MEDLINE
| ID: mdl-34515256
ABSTRACT
OBJECTIVE:
The aim of this study was to evaluate the survival outcomes of radical prostatectomy (RP), external beam radiotherapy plus brachytherapy (EBRT + BT), and EBRT alone among elderly men (aged 70 years and above) with very high-risk (VHR) prostate cancer (PCa).METHODS:
We identified elderly men diagnosed with VHR PCa between 2004 and 2015 in the Surveillance, Epidemiology, and End Results database. The propensity score-matching method was adopted to balance the covariates and generate new cohorts. -Kaplan-Meier and Cox analyses were conducted to build up survival curves and evaluate the overall survival (OS) and PCa-specific survival (PCSS) outcomes.RESULTS:
A total of 9,818 patients were identified. Of them, 5,839 were in the EBRT group, 725 in the EBRT + BT group, and 3,254 in the RP group. The survival curves of the overall cohort showed that RP was associated with the best OS, followed by EBRT + BT and EBRT (p < 0.001). As for the PCSS, RP shared similar outcomes with EBRT + BT (hazard ratio [HR] 1.25 [0.93-1.69], p = 0.175). EBRT was associated with significantly worse PCSS than both RP (HR 1.88, 95% confidence interval [95% CI] [1.64-2.15], p < 0.001) and EBRT + BT (HR 1.48, 95% CI [1.19-1.85], p = 0.002). In the matched cohorts, RP presented better OS (HR 1.41, 95% CI [1.07-1.86], p = 0.041) and similar PCSS with EBRT + BT (HR 1.50, 95% CI [0.91-2.47], p = 0.12). RP was associated with significantly better OS and PCSS outcomes than EBRT alone (OS HR 1.58, 95% CI [1.59-2.12], p < 0.001; PCSS HR 2.08 [1.60-2.72], p < 0.001). EBRT + BT also had significantly better OS and PCSS outcomes than EBRT alone (OS HR 1.33, 95% CI [1.11-1.60], p < 0.001; PCSS HR 1.57 [1.13-2.19], p = 0.003).CONCLUSIONS:
For patients above 70 years with VHR PCa, RP was associated with better OS and similar PCSS than EBRT + BT. Both RP and EBRT + BT have better OS and PCSS than EBRT alone.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Prostatectomia
/
Neoplasias da Próstata
/
Braquiterapia
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
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Humans
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Male
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article