Six-year outcomes of robot-assisted radical prostatectomy versus volumetric modulated arc therapy for localized prostate cancer: A propensity score-matched analysis.
Strahlenther Onkol
; 2024 Jan 05.
Article
em En
| MEDLINE
| ID: mdl-38180494
ABSTRACT
BACKGROUND:
Although robot-assisted radical prostatectomy (RARP) and intensity-modulated radiotherapy are the leading respective techniques of prostatectomy and radiotherapy for localized prostate cancer, almost no study has directly compared their outcomes; none have compared mortality outcomes.METHODS:
We compared 6year outcomes of RARP (nâ¯= 500) and volumetric modulated arc therapy (VMAT, a rotational intensity-modulated radiotherapy, nâ¯= 360) in patients with cT1-4N0M0 prostate cancer. We assessed oncological outcomes, namely overall survival (OS), cancer-specific survival (CSS), radiological recurrence-free survival (rRFS), and biochemical recurrence-free survival (bRFS), using propensity score matching (PSM). We also assessed treatment-related complication outcomes of prostatectomy and radiotherapy.RESULTS:
The median follow-up duration was 79 months (>â¯6 years). PSM generated a matched cohort of 260 patients (130 per treatment group). In the matched cohort, RARP and VMAT showed equivalent results for OS, CSS, and rRFS both achieved excellent 6year outcomes for OS (>â¯96%), CSS (>â¯98%), and rRFS (>â¯91%). VMAT had significantly longer bRFS than RARP, albeit based on different definitions of biochemical recurrence. Regarding complication outcomes, patients who underwent RARP had minimal (2.6%) severe perioperative complications and achieved excellent continence recovery (91.6 and 68.8% of the patients achieved ≤â¯1 pad/day and pad-free, respectively). Patients who underwent VMAT had an acceptable rate (20.0%) of grade ≥â¯2 genitourinary complications and a very low rate (4.4%) of grade ≥â¯2 gastrointestinal complications.CONCLUSION:
On the basis of PSM after a 6-year follow-up, RARP and VMAT showed equivalent and excellent oncological outcomes, as well as acceptable complication profiles.
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MEDLINE
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Ano de publicação:
2024
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Article