Radical prostatectomy versus external beam radiotherapy for localized prostate cancer: Comparison of treatment outcomes.

Abstract

We retrospectively compared the treatment outcomes of localized prostate cancer between radical prostatectomy (RP) and external beam radiotherapy (EBRT). We retrospectively analyzed 738 patients with localized prostate cancer who underwent either RP (n = 549) or EBRT (n = 189) with curative intent at our institution between March 2001 and December 2011. Biochemical failure was defined as a prostate-specific antigen (PSA) level of ≥ 0.2ng/ml in the RP group and the nadir of + ≥ 2ng/ml in the EBRT group. The median (range) follow-up duration was 48.8months (0.7-133.2months) and 48.7months (1.0-134.8 months) and the median age was 66years (45-89years) and 71years (51-84 years; p < 0.001) in the RP and EBRT groups, respectively. Overall, 21, 42, and 36 % of patients in the RP group, and 15, 27, and 58 % of patients in the EBRT group were classified as low, intermediate, and high risk, respectively (p < 0.001). Androgen-deprivation therapy was more common in the EBRT group (59 vs. 27 %, respectively; p < 0.001). The 8-year biochemical failure-free survival rates were 44 and 72 % (p < 0.001) and the disease-specific survival rates were 98 % and 97 % (p = 0.543) in the RP and EBRT groups, respectively. Although the EBRT group included more high-risk patients than did the RP group, the outcomes of EBRT were not inferior to those of RP. Our data suggest that EBRT is a viable alternative to RP for treating localized prostate cancer.