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. 2021 Apr;8(2):227-234.
doi: 10.1016/j.ajur.2020.05.005. Epub 2020 May 23.

Oncological outcomes of patients with ductal adenocarcinoma of the prostate receiving radical prostatectomy or radiotherapy

Mengzhu Liu  1 , Kun Jin  1 , Shi Qiu  1   2 , Pengyong Xu  3 , Mingming Zhang  1 , Wufeng Cai  1 , Xiaonan Zheng  1 , Lu Yang  1 , Qiang Wei  1
Affiliations

Oncological outcomes of patients with ductal adenocarcinoma of the prostate receiving radical prostatectomy or radiotherapy

Mengzhu Liu et al. Asian J Urol. 2021 Apr.

Abstract

Objective: To evaluate the oncological outcomes of ductal adenocarcinoma of the prostate (DAC) managed with radical prostatectomy (RP) or radiotherapy (RT) and optimize the proper treatment modality to DAC comprehensively.

Methods: The cohorts included a total of 528 patients from the Surveillance, Epidemiology and End Results (SEER) database, 354 receiving RP and 174 receiving RT. Cox proportional hazards regressions were performed to assess cancer specific mortality (CSM) and overall mortality (OM) between treatment groups. A competing risk analysis was further conducted. Subgroup analyses by age and level of prostate-specific antigen (PSA) were performed. Propensity score matching was implemented.

Results: Patients managed with RP had lower risks of CSM and OM compared with RT (before matching: Hazard ratio [HR]=0.24, 95% confidence interval [CI] 0.13-0.47 and HR=0.26, 95% CI 0.17-0.40, respectively; after matching: HR=0.18, 95% CI 0.04-0.82 and HR=0.28, 95% CI 0.11-0.70, accordingly). Subgroup analyses demonstrated that patients in the middle tertile of the age or with lower tertile PSA level managed with RP took lower risks of OM significantly (HR=0.18, 95% CI 0.06-0.57, p<0.01 and HR=0.17, 95% CI 0.06-0.54, p<0.01).

Conclusion: Among patients with DAC, treatment with RP was associated with better survival outcomes in comparison with RT. Patients with DAC in the middle tertile of the age and with lower tertile PSA level benefited the most from RP.

Keywords: Cancer specific mortality; Ductal adenocarcinoma of the prostate; Overall mortality; Radical prostatectomy; Radiotherapy.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Kaplan-Meier analyses depicting cancer-specific mortality rates. (A) Survival curves; (B) Number at risk at different times; (C) Number of censoring at different times. RT, radiotherapy; RP, radical prostatectomy.
Figure 2
Figure 2
Kaplan-Meier analyses depicting overall mortality rates. (A) Survival curves; (B) Number at risk at different times; (C) Number of censoring at different times. RT, radiotherapy; RP, radical prostatectomy.
Figure 3
Figure 3
Kaplan-Meier analyses depicting cancer-specific mortality rates after propensity score matching. (A) Survival curves; (B) Number at risk at different times; (C) Number of censoring at different times. RT, radiotherapy; RP, radical prostatectomy.
Figure 4
Figure 4
Kaplan-Meier analyses depicting overall mortality rates after propensity score matching. (A) Survival curves; (B) Number at risk at different times; (C) Number of censoring at different times. RT, radiotherapy; RP, radical prostatectomy.
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