Long-term oncological results of radical prostatectomy in patients with localized prostate cancer

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.

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Comparative results of cryoablation and laparoscopic radical prostatectomy in the treatment of localized prostate cancer

Urologia Journal ◽

10.1177/0391560317749425 ◽

2018 ◽

Vol 85 (2) ◽

pp. 68-72 ◽

Cited By ~ 3

Author(s):

Denis Vladimirovich Chinenov ◽

Leonid Mikhailovich Rapoport ◽

Evgeniy Valerievich Shpot ◽

Dmitry Victorovich Enikeev ◽

Yaroslav Nikolaevich Chernov ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Prostate Specific Antigen ◽

Specific Antigen ◽

Prostate Specific Antigen Level ◽

Localized Prostate Cancer ◽

Antigen Level ◽

Early Results ◽

Oncological Results ◽

Group 1

Aim: To evaluate early prostate cancer cryoablation functional and oncological results in comparison with results of extraperitoneoscopic radical prostatectomy. Materials and methods: We analyzed early results of surgical treatment of 285 patients with prostate cancer: 42 of them had undergone total cryoablation (Group 1) while the rest of them had been treated by radical laparo- and extraperitoneoscopic prostatectomy. For comparative assessment of prostate cryoablation results, 42 patients from Group 2 randomized in accordance with their age, stage of disease, Gleason, prostate-specific antigen, and prostate volume were selected. In compliance with the results of pre-surgical examination, all the patients had low oncological risk and were not concerned in sexual function. Volume of prostate was from 22 to 65 cm3, prostate-specific antigen level was from 4.1 to 10 ng/mL, and level of neoplastic process differentiation using Gleason grading system was from 6 to 7a (3 + 4) scores. Results: Patients after prostate cryoablation in early post-surgical period felt lower intensity of postoperative pain compared with those who had undergone prostatectomy. Follow-up period up to 12 months manifested significant true reduction of prostate-specific antigen level in both groups of patients. Frequency of stress-induced enuresis in Group 1 was not observed. Conclusion: Radical prostatectomy is still the traditional treatment of choice in the case of localized prostate cancer. But we can draw the conclusion that cryoablation is an effective low-invasive method for treatment of low oncological risk patients, which gives the opportunity both to achieve good oncological results and to preserve high life quality.

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Long-term health care resource utilization in men with localized prostate cancer treated with radical prostatectomy: Data from CaPSURE

Journal of Clinical Oncology ◽

10.1200/jco.2005.23.16_suppl.6078 ◽

2005 ◽

Vol 23 (16_suppl) ◽

pp. 6078-6078 ◽

Cited By ~ 1

Author(s):

K. L. Greene ◽

E. P. Elkin ◽

L. Wilson ◽

N. Sadetsky ◽

J. M. Broering ◽

...

Keyword(s):

Prostate Cancer ◽

Health Care ◽

Radical Prostatectomy ◽

Resource Utilization ◽

Health Care Resource ◽

Localized Prostate Cancer ◽

Health Care Resource Utilization

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The influence of race and treatment choice in 16,508 men treated either conservatively, with radiotherapy, or surgically for clinically localized prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.7_suppl.210 ◽

2011 ◽

Vol 29 (7_suppl) ◽

pp. 210-210

Author(s):

P. Sooriakumaran ◽

T. Field ◽

M. John ◽

R. Leung ◽

A. Tewari

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Watchful Waiting ◽

The United States ◽

Research Network ◽

Localized Prostate Cancer ◽

Term Survival ◽

Long Term Survival ◽

Treatment Choices

210 Background: There are known variations in cancer survival based on race and treatment choices. We report the long-term survival probability, based on race, in 16,508 men with localized prostate cancer treated either conservatively or by radiotherapy or radical prostatectomy. Methods: We extracted survival data from tumor registries of six Cancer Research Network sites in the United States. Patients were stratified into four racial groups: Caucasians, African Americans, Hispanics, and Asians. The Cox proportional-hazards regression model was used to compare long-term survival in the three treatment groups. Kaplan-Meier survival curves and competing risk analysis was also performed. Results: Survival was improved for patients who underwent radical prostatectomy compared to radiotherapy or watchful waiting. This was true for all patients combined (Table) as well as for all races individually. Radiotherapy had at least equivalent survival outcomes as watchful waiting in all groups. The differences between treatments were greater for overall survival than for prostate cancer specific survival in all groups, though the extent of the differences varied by race. Conclusions: Radical prostatectomy increases survival in men with localized prostate cancer compared to both radiotherapy and watchful waiting, especially for Caucasian men. Radiotherapy was at least equivalent to watchful waiting for all races. Racial disparities in outcome may influence treatment choices for men with clinically localized prostate cancer. [Table: see text] [Table: see text]

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