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Survival of Prostate Cancer Patients Who Had Either Surgery Or Radiation Therapy

A Dey1*, T Biswas2,3 , S Datta1 , T Podder2,3 , (1) University of Akron, Akron, OH, (2) University Hospitals Seidman Cancer Center, Cleveland, OH, (3)Case Western Reserve University, Cleveland, OH


(Sunday, 7/14/2019)  

Room: ePoster Forums

Purpose: Two major treatment options for low-risk and intermediate-risk prostate cancer (CaP) patients are surgery and radiation therapy (RT), which may have different clinical outcomes. In this study, relative efficacy of surgery and RT has been evaluated in terms of overall survival (OS).

Methods: Analyzed National Cancer Database (NCDB) for Stage T1-2c prostate cancer patients treated between 2004-2015. Patients were stratified NCCN guidelines: low-risk (Stage: T1-T2a, GS=6, and PSA<10), intermediate-risk (Stage: T2b or T2c, GS=7, or PSA:10-20). Considered two groups of patients: (1) surgery patients who did not receive any RT (n=451,679), and (2) non-surgery patients who received RT only (n=270,596). All modalities of EBRT (3DCRT, IMRT, SBRT), Proton and brachytherapy (LDR and HDR) were included in RT group. Considered total dose: 70-81Gy for IMRT, 3DCRT and Proton; 30-40Gy for SBRT; monotherapy was considered for LDR and HDR. IBM SPSS software (version-24.0) was used for statistical analysis; p-value <0.05 was considered statistically significant.

Results: Median age of the patients in surgery group was 62 years (range:28-90) and that for RT group were 68 years (range:29-90). Median follow-up was 68.8 months. Observed significantly better mean OS (about 5.7% and 14.5% higher, in low-risk and intermediate-risk patients, respectively (p-value<0.001)) in surgery group. 5-year and 10-year survival for these patients were about 3% and 9%, respectively, higher in surgery group (p-value<0.01)) in surgery group. Low-risk patients performed better compared to intermediate-risk patients in both surgery and radiation groups.

Conclusion: This study indicates that for low-risk and intermediate-risk prostate cancers, surgery is preferable over RT (62.5% vs. 37.5%). Overall survival in surgery is better as compared to RT. However, it is unclear whether the baseline health conditions of the patients in surgery group and RT group were comparable, that might be favorable for improved OS in surgery group. Multivariable risk model analysis is underway.


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