Mortality and biochemical recurrence after surgery, brachytherapy, or external radiotherapy for localized prostate cancer : a 10-year follow-up cohort study
Suárez, José Francisco (Hospital Universitari de Bellvitge)
Zamora, Víctor (Institut Hospital del Mar d'Investigacions Mèdiques)
Garin, Olatz (Institut Hospital del Mar d'Investigacions Mèdiques)
Gutiérrez, Cristina (Institut Català d'Oncologia)
Pont, Angels (Institut Hospital del Mar d'Investigacions Mèdiques)
Pardo Cladellas, Yolanda (Institut Hospital del Mar d'Investigacions Mèdiques)
Goñi, Alai (Fundación Onkologikoa - UGC Oncología Gipúzcoa)
Mariño, Alfonso (Centro Oncológico de Galicia)
Hervás, Asunción (Hospital Universitario Ramón y Cajal (Madrid))
Herruzo, Ismael (Hospital Regional Universitario de Málaga)
Cabrera, Patricia (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Sancho-Pardo, Gemma (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Ponce de León Roca, Javier (Fundació Puigvert)
Macías Hernández, Víctor (Hospital Universitari i Politècnic La Fe (València))
Guedea, Ferran (Institut Català d'Oncologia)
Vigués, Francesc (Hospital Universitari de Bellvitge)
Castells, Manel (Hospital Universitari de Bellvitge)
Ferrer Forés, Maria Montserrat (Institut Hospital del Mar d'Investigacions Mèdiques)
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	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 125 I 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 are provided on the effectiveness of brachytherapy to control localized prostate cancer ten years after treatment, compared to radical prostatectomy and external radiotherapy, presenting high overall survival, similarly to radical prostatectomy, but higher risk of biochemical progression. These findings provide valuable information to facilitate shared clinical decision-making. Study identifier at ClinicalTrials. gov : NCT01492751.
Ayudas:	Ministerio de Ciencia e Innovación PI08/90090 Ministerio de Economía y Competitividad PI13/00412 Instituto de Salud Carlos III PI21/00023
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Outcomes research ; Prostate ; Prostate cancer
Publicado en:	Scientific reports, Vol. 12 (july 2022) , ISSN 2045-2322

DOI: 10.1038/s41598-022-16395-w
PMID: 35869124

9 p, 1.6 MB

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