caa a22 4500 445335483 CHVBK 20180317142753.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-1660-0 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1660-0 Radical Prostatectomy Versus External-Beam Radiotherapy for Localized Prostate Cancer: Long-Term Effect on Biochemical Control—In Search of the Optimal Treatment [Elektronische Daten] [Carmen González-San Segundo, Felipe Herranz-Amo, Ana Álvarez-González, Pedro Cuesta-Álvaro, Marina Gómez-Espi, Eva Paños-Fagundo, Juan Santos-Miranda] Background: The optimal management of patients with clinically localized prostate carcinoma remains undefined due in part to the absence of well-designed, randomized trials. Methods: This retrospective study comprised 505 patients diagnosed with low- or intermediate- risk prostate cancer in 1998-2005 and treated at Hospital Gregorio Marañón (Spain) with radical prostatectomy (RP) or external-beam radiotherapy (EBRT). No adjuvant therapy was administered. Biochemical relapse was defined as a prostate-specific antigen (PSA) level ≥0.4ng/ml for RP cases and nadir+2 for EBRT cases. RP was performed in 271 patients (53.6%) and EBRT in 234 patients (46.4%). The median follow-up was 60months. The analysis end point was to compare the biochemical recurrence-free survival (bRFS) between the two groups. Results: The 5-year bRFS rates for RP and EBRT were 79±2% and 86±2%, respectively (P=0.48). Multivariate analysis indicated that initial PSA (P=0.00), perineural invasion in the biopsy specimen (P=0.00), Gleason score (P=0.04), EBRT dose (P=0.02), and positive margins (P=0.00) were independent predictors of relapse. A decision tree model was constructed with these variables. In the EBRT cohort, a nadir PSA of <0.3ng/ml was associated with the best 5-year bRFS (96.6 vs. 56.5% if nadir PSA>1.3ng/ml). Late biochemical failure (>5years) was more frequent in the RT group and with low-dose EBRT (≤72Gy). Conclusions: The biochemical failure rates were similar between PR and EBRT in low- and intermediate-risk subgroups. Outcome was determined by classic pre-treatment features, perineural invasion, low-dose EBRT (≤72Gy), and nadir PSA value in the RT cohort. Society of Surgical Oncology, 2011 González-San Segundo Carmen Radiation Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain aut Herranz-Amo Felipe Urology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain aut Álvarez-González Ana Radiation Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain aut Cuesta-Álvaro Pedro Statistical Investigation Department, Universidad Complutense de Madrid, Madrid, Spain aut Gómez-Espi Marina Radiation Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain aut Paños-Fagundo Eva Urology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain aut Santos-Miranda Juan Radiation Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain aut Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2980-2987 1068-9265 18:10<2980 2011 18 10434 https://doi.org/10.1245/s10434-011-1660-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1660-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- González-San Segundo Carmen Radiation Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain aut NATIONALLICENCE 700 1- Herranz-Amo Felipe Urology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain aut NATIONALLICENCE 700 1- Álvarez-González Ana Radiation Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain aut NATIONALLICENCE 700 1- Cuesta-Álvaro Pedro Statistical Investigation Department, Universidad Complutense de Madrid, Madrid, Spain aut NATIONALLICENCE 700 1- Gómez-Espi Marina Radiation Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain aut NATIONALLICENCE 700 1- Paños-Fagundo Eva Urology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain aut NATIONALLICENCE 700 1- Santos-Miranda Juan Radiation Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2980-2987 1068-9265 18:10<2980 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer