Comparative effectiveness of radical prostatectomy and curative radiotherapy in localized prostate cancer: long-term follow-up

Disease Specific Survival ◽

Long Term Follow Up ◽

Disease Specific

This chapter provides a summary of the landmark PIVOT trial that randomized men with clinically localized prostate cancer from the early prostate-specific antigen (PSA) era to radical prostatectomy versus watchful waiting. Based on long-term follow-up, the study found that surgery provided only small reductions in disease-specific survival but caused substantial side effects. It suggested that many men with clinically localized prostate cancer fare well with watchful waiting.

Intensity-modulated radiotherapy versus radical prostatectomy in patients with localized prostate cancer: long-term follow-up

BMC Cancer ◽

10.1186/1471-2407-13-530 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 34

Author(s):

Tomás Merino ◽

Ignacio F San Francisco ◽

Pablo A Rojas ◽

Piero Bettoli ◽

Álvaro Zúñiga ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Intensity Modulated Radiotherapy ◽

Intensity Modulated ◽

Inductive androgen deprivation and radical prostatectomy in T4 prostate cancer: Consecutive assessment of perioperative outcomes and long-term follow up

European Urology Supplements ◽

10.1016/s1569-9056(19)30217-9 ◽

2019 ◽

Vol 18 (1) ◽

pp. e299-e300

Author(s):

M. Saar ◽

C. Niklas ◽

T. Hajili ◽

C-H. Ohlmann ◽

J. Linxweiler ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Androgen Deprivation ◽

Perioperative Outcomes ◽

Long-Term Oncologic Outcome of an Initial Series of Laparoscopic Radical Prostatectomy for Clinically Localized Prostate Cancer After a Median Follow-up of 10 Years

Clinical Genitourinary Cancer ◽

10.1016/j.clgc.2015.11.006 ◽

2016 ◽

Vol 14 (4) ◽

pp. 290-297 ◽

Cited By ~ 3

Author(s):

Ashkan Mortezavi ◽

Tullio Sulser ◽

Jacopo Robbiani ◽

Eva Drescher ◽

Daniel Disteldorf ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Oncologic Outcome ◽

Laparoscopic Radical Prostatectomy ◽

Initial Series

Abstract 4197: Long-term follow-up of a racially and ethnically diverse population of patients with localized prostate cancer who did not undergo initial active treatment

10.1158/1538-7445.sabcs18-4197 ◽

2019 ◽

Author(s):

Jeff Slezak ◽

Stephen Van Den Eeden ◽

Kimberly L. Cannavale ◽

Gary W. Chein ◽

Chun R. Chao

Keyword(s):

Prostate Cancer ◽

Active Treatment ◽

Ethnically Diverse ◽

Diverse Population ◽

Corrigendum to “Re: Clinical Results of Long-Term Follow-Up of a Large, Active Surveillance Cohort with Localized Prostate Cancer” [Eur Urol 2010;58:179–80]

European Urology ◽

10.1016/j.eururo.2010.06.028 ◽

2010 ◽

Vol 58 (3) ◽

pp. 474

Author(s):

Guillaume Ploussard ◽

Pierre Mongiat-Artus

Keyword(s):

Prostate Cancer ◽

Active Surveillance ◽

Clinical Results ◽

Long-Term Clinical Outcomes of Radical Prostatectomy versus Watchful Waiting in Localized Prostate Cancer Patients: A Systematic Review and Meta-Analysis

Iranian Journal of Public Health ◽

10.18502/ijph.v48i4.978 ◽

2019 ◽

Author(s):

Mojtaba NOUHI ◽

Seyed Masood MOUSAVI ◽

Alireza OLYAEEMANESH ◽

Nasser SHAKSISALIM ◽

Ali AKBARI SARI

Keyword(s):

Prostate Cancer ◽

Urinary Incontinence ◽

Radical Prostatectomy ◽

Clinical Outcomes ◽

Watchful Waiting ◽

Controlled Trials ◽

All Cause Mortality

Background: The present study aimed to compare the long-term clinical and functional outcomes of patients with clinically localized prostate cancer treated with radical prostatectomy compared to the watchful waiting. Methods: PubMed, Cochrane Central Register of Controlled Trials and reference lists of relevant marker studies were scrutinized from inception to Jan 2018. Two reviewers conducted data abstraction and quality assessment of included trials independently. Quality of included studies were assessed by using Cochrane checklist. Inverse-variance and Mantel-Haenszel estimates under random effects model were used to pool results as relative risks with 95% confidence interval. Heterogeneity was assessed by using I2. Results: Three randomized controlled trials with 1568 participants were included. Compared to watchful waiting, radical prostatectomy had no significant effect on all-cause mortality at 12-year follow-up. However, radical prostatectomy had significant effect on reducing prostate-cause mortality at 12-year follow-up. We found significant lower prostate-cause mortality in patients with PSA>10 and GS≥7 scores who had undergone radical prostatectomy compared with patients in watchful waiting group. In addition, younger patients undergoing surgery developed lower distant metastases rate compared to another approach. Watchful waiting had a significant effect on erectile and urinary incontinence during 2 years. Conclusion: There was no significant difference between radical prostatectomy and watchful waiting on all-cause mortality. However, the radical prostatectomy was associated with statistically lower prostate-cause mortality and metastases rates. Compared with older men, younger men experienced better clinical outcomes. Moreover, watchful waiting had better effect on reducing erectile dysfunction and urinary incontinence among patients during 2 years compared to radical prostatectomy.

Long-term QOL outcome after proton beam monotherapy for localized prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.7_suppl.68 ◽

2011 ◽

Vol 29 (7_suppl) ◽

pp. 68-68

Author(s):

J. Coen ◽

J. J. Paly ◽

E. A. Weyman ◽

A. Rodrigues ◽

W. U. Shipley ◽

...

Keyword(s):

Prostate Cancer ◽

Sexual Dysfunction ◽

Functional Groups ◽

Normal Function ◽

High Dose ◽

Proton Radiation ◽

68 Background: High-dose conformal proton radiation for localized prostate cancer results in favorable clinical outcomes and low toxicity rates. Here, we report long-term quality of life (QOL) outcome for men treated with conformal protons. Methods: Serial QOL questionnaires were administered to men who received proton radiation. Long-term questionnaires (minimum 2 years) were completed by 72 patients. Men were stratified into functional groups from their baseline questionnaires (normal, intermediate or poor function) for each symptom domain. Symptom scores were calculated at baseline and long-term follow-up and expressed as mean values. QOL changes were assessed overall and within functional groups in a paired fashion using the Student's t-test. Results: The median age at treatment and follow-up were 66 years and 44 months, respectively. The median dose was 82 GyE (range 74-82 GyE). For all 72 patients, there were increased scores for incontinence (ID) (3.2 baseline vs. 9.9 long-term, p=<0.001), obstructive/irritative voiding (OID; 20 vs. 24, p=0.028), bowel (BD; 4.4 vs. 8.0, p=0.001) and sexual dysfunction (SD; 25 vs. 48, p<0.001). When stratified by functional category, more specific estimates were possible. For ID, only normal function was associated with a significant increased score (0 vs. 8.4 at baseline and long-term, p=<0.001); for OID, only the group with normal baseline function showed a significant increased score (12 vs. 17, p=0.01); similarly for BD, only men with normal function had a significant increased score (0 vs. 5.4, p<0.001). For SD, the score increased in men with normal (1.4 vs. 30, p<0.001) and intermediate function (17 vs. 46, p<0.001). Conclusions: Patient reported outcomes are sensitive indicators of treatment related sequelae and here quantitate, for the first time, the long-term consequences of proton monotherapy for prostate cancer. Analysis by baseline functional category is a useful means of predicting long-term QOL scores for an individual patient. High-dose proton radiation was associated with small increases in bowel dysfunction, obstructive/irritative voiding dysfunction and incontinence. With long term follow-up, sexual dysfunction increased more than any other symptom domain. No significant financial relationships to disclose.