S&T-53 TEN-YEAR OUTCOMES OF TREATMENT FOR LOCALIZED PROSTATE CANCER IN A SINGLE INSTITUTION; COMPARISON OF RADICAL PROSTATECTOMY VS RADIATION THERAPY ~PROPENSITY SCORE MATCHING ANALYSIS~

Abstract

You have accessJournal of UrologyScience & Technology Posters1 Apr 2016S&T-53 TEN-YEAR OUTCOMES OF TREATMENT FOR LOCALIZED PROSTATE CANCER IN A SINGLE INSTITUTION; COMPARISON OF RADICAL PROSTATECTOMY VS RADIATION THERAPY ~PROPENSITY SCORE MATCHING ANALYSIS~ Narihiko Hayashi, Yumiko Yokomizo, Kimito Osaka, Kazuhikde Makiyama, Noboru Nakaigawa, Masahiro Yao, and Masataka Taguri Narihiko HayashiNarihiko Hayashi More articles by this author , Yumiko YokomizoYumiko Yokomizo More articles by this author , Kimito OsakaKimito Osaka More articles by this author , Kazuhikde MakiyamaKazuhikde Makiyama More articles by this author , Noboru NakaigawaNoboru Nakaigawa More articles by this author , Masahiro YaoMasahiro Yao More articles by this author , and Masataka TaguriMasataka Taguri More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2882AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Radical prostatectomy (RP), intensity modulated radiation therapy (IMRT) and brachytherapy (BT) are three major definitive treatment modalities for localized prostate cancer in recent years. While a lot of technical progress are seen in this decade, patients with localized prostate cancer are often struggling with making a decision of their treatment. It might be due to luck of information in terms of comparing the outcomes among these modalities since only few reports are seen in the literature. 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 three treatment modalities in a single institution in Japan. METHODS From Jan 2004 to Aug 2014, a group of 1943 patients with clinically localized prostate cancer treated with RP (454pts), IMRT (343pts) and BT(1146pts) were identified in our institution. The records of RP (n=362), IMRT (n=225) and BT (n=826) patients with a minimum of 2 years of follow-up (total 1413) were reviewed. Propensity scores were calculated using multivariable logistic regression based on the covariates including patient's age, preoperative PSA, Gleason score, number of positive cores, clinical T stage. Each cohort were categorized according to NCCN risk classification and biochemical outcomes plus overall survival were examined. Biochemical failure was defined as RP: PSA >0.2ng/ml, IMRT, BT: nadir PSA level +2ng/ml. RESULTS Median follow-up was 69.1 months (mo) for RP, 51.0 mo for IMRT and 57.3 mo for BT patients. After adjustment of propensity scores, a total of 260 patients (130 each) and 428 patients (214 each) were matched for RP vs IMRT cohort and RP vs BT cohort, respectively. Kaplan-Meier analysis did not show any statistically significant differences in terms of overall survival in these two cohorts (RP vs IMRT:p=0.421, RP vs BT:p=0.764). Regarding biochemical failure free survival, there was statistically significant differences in all risk group in RP vs IMRT cohort (High-risk: p=0.000, Intermediate-risk: p=0.001, Low-risk: p=0.007), while significant differences were observed in low (p=0.003), intermediate (p=0.006) risk group among RP vs BT cohort. CONCLUSIONS Our mid-term outcomes for localized prostate cancer using propensity score analysis demonstrated no significant differences in overall survival. Despite the difference of biochemical failure definition, IMRT and BT improved biochemical failure free survival compared to RP with excellent tumor control in Japanese people © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e330 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Narihiko Hayashi More articles by this author Yumiko Yokomizo More articles by this author Kimito Osaka More articles by this author Kazuhikde Makiyama More articles by this author Noboru Nakaigawa More articles by this author Masahiro Yao More articles by this author Masataka Taguri More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...