1220 COMPARISON OF RADICAL PROSTATECTOMY VS LOW DOSE BRACHYTHERAPY FOR CLINICALLY LOCALIZED PROSTATE CANCER ∼PROPENSITY SCORE MATCHING ANALYSIS∼

Abstract

You have accessJournal of UrologyProstate Cancer: Localized1 Apr 20131220 COMPARISON OF RADICAL PROSTATECTOMY VS LOW DOSE BRACHYTHERAPY FOR CLINICALLY LOCALIZED PROSTATE CANCER ∼PROPENSITY SCORE MATCHING ANALYSIS∼ Narihiko Hayashi, Futoshi Sano, Hiroji Uemura, and Yoshinobu Kubota Narihiko HayashiNarihiko Hayashi Yokohama, Japan More articles by this author , Futoshi SanoFutoshi Sano Yokohama, Japan More articles by this author , Hiroji UemuraHiroji Uemura Yokohama, Japan More articles by this author , and Yoshinobu KubotaYoshinobu Kubota Yokohama, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2574AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Both radical prostatectomy(RP) and brachytherapy(BT) are widely accepted treatments for clinically localized prostate cancer. In the recent literature, a few studies have demonstrated that RP was associated with statistically significant improvement in overall survival. Propensity score matching analysis in nonrandomized studies is to balance the treatment and comparison groups on observed preintervention characteristics. Though it may not be considered an equivalent to randomized trial, it reduces to a minimum the inherent treatment selection bias associated with retrospective data. We analyzed the results of two treatment modalities in Japan. METHODS From March 2004 to February 2012, a group of 1152 patients with clinically localized prostate cancer treated with I125 BT(789pts) and radical RP(363pts) were identified in our institution. The records of 490 (BT) and 250 (RP) patients with a minimum of 2 years of follow-up were reviewed. Propensity scores were calculated using multivariable logistic regression based on the covariates including patient age, preoperative PSA, biopsy Gleason score, positive cores and clinical T stage. Each cohorts were categorized according to NCCN risk classification and biochemical outcomes plus overall survival were examined. Biochemical failure was defined as nadir PSA level +2ng/ml for BT and PSA >0.2ng/ml for RP. RESULTS Median follow-up was 51.5 months for BT patients and 59.2 months for RP patients. Overall biochemical failure free survival was 93.8% for BT patients and 64.8% for RP patients. After adjustment of propensity scores, a total of 314 patients (157each) were matched in this study. Kaplan-Meier analysis did not show any statistically significant differences in terms of overall survival between two cohorts (p=0.159). Regarding biochemical failure free survival, there was statistically significant differences in low risk group (BT:98.2% vs RP:72.3%) between two cohorts (p=0.0011), while no significant differences were observed in intermediate (p=0.1093) and high (p=0.2432) risk group. CONCLUSIONS Contrary to the reports from U.S. and Europe, our study using propensity score analysis demonstrated no statistically significant difference in overall survival. Despite the difference of biochemical failure definition, BT improved biochemical free survival compared to RP with excellent tumor-control outcomes in Japanese people. These results may arise from the difference of tumor malignancy among races and/or matured brachytherapy procedure. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e500 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Narihiko Hayashi Yokohama, Japan More articles by this author Futoshi Sano Yokohama, Japan More articles by this author Hiroji Uemura Yokohama, Japan More articles by this author Yoshinobu Kubota Yokohama, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...