AIM: to compare long-term survival of patients with high-risk prostate cancer (PCa)after radical prostatectomy (RP) and external beam radiotherapy (EBRT) with adjuvant androgen-deprivation therapy (ADT).
METHODS: medical data of 547 consecutive patients with high risk PCa were analyzed. RP was performed in 372 (68%), EBRT+ADT – in 175 (32%) cases. Frequencies of age >65 years, PSA>20 ng/ml, biopsy Gleason sum 7-10, categories cT3-4 and cN+ were higher in EBRT group (p<0.05). The median follow-up was 56 (6-210) months.
RESULTS: 8-year biochemical recurrence free (bRFS), cancer-specific (CSS) and overall survival in patients undergone RP and EBRT+ADT was 41.4% vs 53.5% (p<0.0001), 92.3% and 94.8% (p=0.389), 84.4% and 79.5% (p=0.034) respectively. Stratification of results according to categories T, N, and Gleason score confirmed advantage of bRFS in EBRT+ADT group in PCa T3-4N0 (31.4% vs 59.5%, p<0.0001), N+ (8.9% vs 46.2%, p<0.0001), and Gleason sum 8-10 (21.1% vs 50.5%, p<0.0001). However, the increase of bRFS did not improve CSS in all subgroups of patients.
CONCLUSIONS: RP and EBRT+ADT provided similar long-term survival in patients with high-risk pCa. Further studies are needed in order to determine criteria for individual treatment selection.
