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International Journal of Clinical Oncology
Published in: International Journal of Clinical Oncology 6/2014

01-12-2014 | Original Article

Long-term oncological outcome in men with T3 prostate cancer: radical prostatectomy versus external-beam radiation therapy at a single institution

Authors: Shinya Yamamoto, Satoru Kawakami, Junji Yonese, Yasuhisa Fujii, Shinji Urakami, Shinichi Kitsukawa, Hitoshi Masuda, Yuichi Ishikawa, Takuyo Kozuka, Masahiko Oguchi, Atsushi Kohno, Iwao Fukui

Published in: International Journal of Clinical Oncology | Issue 6/2014

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Abstract

Background

This study was designed to compare the long-term oncological outcome of patients with clinical T3 (cT3) prostate cancer (PCA) treated with either radical prostatectomy (RP) or external-beam radiation therapy (EBRT) and to identify predictors of oncological outcomes.

Methods

A total of 231 patients with cT3 PCA underwent either RP (n = 112) or EBRT (n = 119). Local progression-free (LPFS), distant metastasis-free (DMFS), cancer-specific (CSS), and overall survival curves were generated with the Kaplan–Meier method, and the differences in survival rates between the two groups were assessed with a log-rank test. Cox proportional stepwise multivariate analysis was used to assess the association of variables to the oncological outcomes.

Results

The median follow-up of the RP and EBRT groups was 93 and 85 months, respectively (p = 0.004).The 10-year LPFS, DMFS, and CSS rates were not statistically different between the two groups (90.2, 73.9, and 93.7 % in the RP group and 82.7, 88.2, and 85.1 % in the EBRT group; p = 0.25, 0.10, and 0.10, respectively). The Cox proportional multivariate analysis revealed that clinical T3b (cT3b) (p = 0.001) and a biopsy Gleason score of 7–10 (p = 0.043) were significant predictors of cancer-specific mortality and that cT3b was also a significant predictor of local progression and all-cause mortality.

Conclusion

In cT3 PCA, both RP and EBRT provide an excellent long-term oncological outcome. cT3b was the strongest predictor of oncological outcome for the patients with locally advanced PCA who underwent the definitive therapy.
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Metadata
Title
Long-term oncological outcome in men with T3 prostate cancer: radical prostatectomy versus external-beam radiation therapy at a single institution
Authors
Shinya Yamamoto
Satoru Kawakami
Junji Yonese
Yasuhisa Fujii
Shinji Urakami
Shinichi Kitsukawa
Hitoshi Masuda
Yuichi Ishikawa
Takuyo Kozuka
Masahiko Oguchi
Atsushi Kohno
Iwao Fukui
Publication date
01-12-2014
Publisher
Springer Japan
Published in
International Journal of Clinical Oncology / Issue 6/2014
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-013-0654-2

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