Comparison of the Oncological and Functional Outcomes of Brachytherapy and Radical Prostatectomy for Localized Prostate Cancer
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Radical Prostatectomy
2.3. Brachytherapy
2.4. Follow-Up
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
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Characteristic | BT (n = 245) | RP (n = 312) | Total (n = 557) | p Value |
---|---|---|---|---|
Age (years) | <0.01 | |||
Range | 53–86 | 49–83 | 49–86 | |
Median | 75 | 64 | 68 | |
Mean (SD) | 74.16 (6.40) | 63.87 (7.66) | 68.40 (8.77) | |
Initial PSA (ng/mL) | 0.141 | |||
≤4, n (%) | 8 (3.3) | 8 (2.6) | 16 (2.9) | |
4–10, n (%) | 68 (27.7) | 111 (35.6) | 179 (32.1) | |
>10, n (%) | 169 (69.0) | 193 (61.8) | 362 (65.0) | |
Mean (SD) | 17.81 (9.12) | 15.34 (8.6) | 16.43 (8.91) | <0.01 |
Biopsy Gleason score | 0.427 | |||
≤6, n (%) | 127 (51.8) | 178 (57.0) | 305 (54.8) | |
7, n (%) | 69 (28.2) | 82 (26.3) | 151 (27.1) | |
≥8, n (%) | 49 (20) | 52 (16.7) | 101 (18.1) | |
Clinical T stage | 0.938 | |||
T1c, n (%) | 40 (16.3) | 48 (15.4) | 88 (15.8) | |
T2a, n (%) | 65 (26.5) | 84 (26.8) | 149 (26.8) | |
T2b, n (%) | 53 (21.6) | 63 (20.2) | 116 (20.8) | |
T2c, n (%) | 78 (31.9) | 108 (34.6) | 186 (33.4) | |
T3a, n (%) | 9 (3.7) | 9 (2.9) | 18 (3.2) | |
NCCN risk category | 0.606 | |||
Low, n (%) | 42 (17.1) | 61 (19.6) | 103 (18.5) | |
Intermediate, n (%) | 61 (24.9) | 83 (26.6) | 144 (25.8) | |
High, n (%) | 142 (58) | 168 (53.8) | 310 (55.7) |
Factor | Multivariate | ||
---|---|---|---|
HR | 95% CI | p Value | |
Treatment modality | 0.082 | ||
RP vs. BT | 1.534 | 0.95–2.48 | |
Age (years) | 0.271 | ||
>65 vs. ≤65 | 1.329 | 0.80–2.21 | |
iPSA (ng/mL) | 0.841 | ||
>10 vs. ≤10 | 1.059 | 0.61–1.85 | |
Gleason score | |||
≤6 | 1 | Ref. | - |
7 | 1.574 | 0.91–2.72 | 0.105 |
≥8 | 3.669 | 2.06–6.53 | <0.001 |
Clinical T stage | |||
≥T2b vs. ≤T2a | 1.264 | 0.79–2.03 | 0.335 |
BT n = 245 (Mean ± SD) | RP n = 312 (Mean ± SD) | p Value (BT vs. RP) | |
---|---|---|---|
Urinary function | |||
Baseline | 96.4 ± 11.2 | 94.5 ± 10.4 | 0.039 |
3-month | 87.5 ± 14.3 | 81.7 ± 17.6 | <0.001 |
6-month | 92.6 ± 8.9 | 86.3 ± 14.2 | <0.001 |
12-month | 93.9 ± 12.2 | 89.1 ± 13.4 | <0.001 |
24-month | 95.3 ± 10.7 | 93.8 ± 11.3 | 0.112 |
Urinary irritative/obstructive | |||
Baseline | 95.1 ± 12.9 | 93.3 ± 11.1 | 0.078 |
3-month | 81.3 ± 15.7 | 85.4 ± 13.6 | <0.001 |
6-month | 85.7 ± 12.5 | 91.4 ± 5.9 | <0.001 |
12-month | 88.3 ± 10.2 | 92.6 ± 4.5 | <0.001 |
24-month | 95.5 ± 8.7 | 94.2 ± 5.3 | 0.03 |
Urinary incontinence | |||
Baseline | 97.9 ± 6.3 | 96.5 ± 7.6 | 0.021 |
3-month | 94.3 ± 7.5 | 68.5 ± 23.5 | <0.001 |
6-month | 96.5 ± 9.7 | 76.9 ± 19.3 | <0.001 |
12-month | 97.5 ± 8.6 | 84.2 ± 16.4 | <0.001 |
24-month | 96.7 ± 8.9 | 95.2 ± 12.9 | 0.121 |
Urinary bother | |||
Baseline | 94.6 ± 8.8 | 93.4 ± 12.1 | 0.193 |
3-month | 85.3 ± 16.1 | 87.6 ± 15.4 | 0.087 |
6-month | 88.4 ± 11.4 | 90.4 ± 10.2 | 0.03 |
12-month | 92.6 ± 10.1 | 92.9 ± 9.1 | 0.713 |
24-month | 93.9 ± 9.2 | 93.1 ± 8.7 | 0.294 |
Bowel function | |||
Baseline | 97.5 ± 5.2 | 96.1 ± 7.3 | 0.011 |
3-month | 95.1 ± 8.5 | 95.2 ± 8.8 | 0.893 |
6-month | 95.9 ± 8.7 | 94.9 ± 7.5 | 0.146 |
12-month | 96.3 ± 6.1 | 95.3 ± 6.7 | 0.070 |
24-month | 97.0 ± 5.7 | 95.9 ± 5.4 | 0.02 |
Bowel bother | |||
Baseline | 98.1 ± 3.6 | 97.7 ± 4.3 | 0.243 |
3-month | 95.8 ± 7.2 | 96.7 ± 7.4 | 0.150 |
6-month | 97.1 ± 6.8 | 96.9 ± 6.8 | 0.731 |
12-month | 97.3 ± 4.8 | 97.2 ± 6.2 | 0.835 |
24-month | 97.9 ± 4.1 | 97.5 ± 5.8 | 0.361 |
Sexual function | |||
Baseline | 47.8 ± 25.5 | 53.1 ± 24.7 | 0.014 |
3-month | 44.5 ± 18.8 | 22.1 ± 22.5 | <0.001 |
6-month | 45.8 ± 20.1 | 28.9 ± 20.6 | <0.001 |
12-month | 46.7 ± 23.4 | 38.8 ± 22.9 | <0.001 |
24-month | 47.5 ± 22.7 | 49.7 ± 22.3 | 0.252 |
Sexual bother | |||
Baseline | 82.1 ± 20.4 | 80.6 ± 22.8 | 0.42 |
3-month | 78.7 ± 22.6 | 62.4 ± 25.7 | <0.001 |
6-month | 80.9 ± 21.1 | 66.3 ± 26.1 | <0.001 |
12-month | 81.9 ± 19.5 | 69.1 ± 23.3 | <0.001 |
24-month | 81.3 ± 19.9 | 77.8 ± 24.8 | 0.072 |
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Wang, F.; Luan, Y.; Fan, Y.; Huang, T.; Zhu, L.; Lu, S.; Tao, H.; Sheng, T.; Chen, D.; Ding, X. Comparison of the Oncological and Functional Outcomes of Brachytherapy and Radical Prostatectomy for Localized Prostate Cancer. Medicina 2022, 58, 1387. https://doi.org/10.3390/medicina58101387
Wang F, Luan Y, Fan Y, Huang T, Zhu L, Lu S, Tao H, Sheng T, Chen D, Ding X. Comparison of the Oncological and Functional Outcomes of Brachytherapy and Radical Prostatectomy for Localized Prostate Cancer. Medicina. 2022; 58(10):1387. https://doi.org/10.3390/medicina58101387
Chicago/Turabian StyleWang, Fei, Yang Luan, Yaqin Fan, Tianbao Huang, Liangyong Zhu, Shengming Lu, Huazhi Tao, Tao Sheng, Deqing Chen, and Xuefei Ding. 2022. "Comparison of the Oncological and Functional Outcomes of Brachytherapy and Radical Prostatectomy for Localized Prostate Cancer" Medicina 58, no. 10: 1387. https://doi.org/10.3390/medicina58101387