Comparison of radical prostatectomy and external beam radiotherapy in high-risk prostate cancer

Radiat Oncol J. 2021 Sep;39(3):231-238. doi: 10.3857/roj.2021.00486. Epub 2021 Sep 9.

Abstract

Purpose: We evaluated clinical outcomes of high-risk prostate cancer patients receiving external beam radiotherapy (EBRT) or radical prostatectomy (RP).

Materials and methods: Patients were classified as high-risk prostate cancer and received definitive treatment between 2005 and 2015. Patients with previous pelvic radiotherapy, positive lymph node or distant metastasis were excluded. The primary outcomes were prostate cancer-specific survival (PCSS) and distant metastasis-free survival (DMFS).

Results: Of 583 patients met the inclusion criteria (77 EBRT and 506 RP). The estimated 10-year PCSS was 97.0% in the RP and 95.9% in the EBRT (p = 0.770). No significant difference was seen in the DMFS (p = 0.540), whereas there was a trend in favor of RP over EBRT in overall survival (OS) (p = 0.068). Propensity score matching analysis with confounding variables was done, with 183 patients (66 EBRT and 117 RP) were included. No significant difference in DMFS, PCSS or OS was found.

Conclusion: Our data demonstrated similar oncologic PCSS, OS, and DMFS outcomes between EBRT and RP patients.

Keywords: Prostate cancer; Prostatectomy; Radiotherapy.