許志呈1、 陳俊佑2、溫玉清1,3、 李良明1, 3
1台北醫學大學-台北市立萬芳醫院 泌尿科；2台北醫學大學-台北市立萬芳醫院 放射腫瘤科；
3台北醫學大學 醫學院 泌尿學科
Treatment Result of High Risk Localized Prostate Cancer in Taiwan- A Single Center Experience
Chih-Chen Hsu1, Chun-You Chen2, Yu-Ching Wen1, 3, , Ke-Hsun Lin1, 3,Yung-Wei Lin1, 3,Chung-Chi Liu1, Liang-Ming Lee1, 3
1 Department of Urology, Wan Fang Hospital, Taipei Medical University
2Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University
3 Department of Urology, School of Medicine, College of Medicine, Taipei Medical University
Purpose: To compare the efficacy of radical prostatectomy (RP), primary androgen deprivation therapy(ADT), radiation therapy (RT) with ADT to high risk prostate cancer patients.
Materials and Methods: Wanfang Cancer Registry Database of Prostate Cancer (WF-CRDPC) is a cohort of all patients diagnosed and treated in a single center since 2004. In this study, we analyzed clinical high risk, localized prostate cancer patients in the WF-CRDPC. The definition of high risk, localized prostate cancer is the same as The National Comprehensive Cancer Network guideline for prostate cancer: clinical stage T3a with American Joint Committee on Cancer (AJCC) 7th edition or PSA greater than 20ng/mL or Gleason score 8-10. Total 87 patients were included in this analysis(N=8, 22, 48 in RP, RT+ADT, and ADT alone group respectively). Progression of prostate cancer is defined as PSA > 2ng/mL or elevation 25% compaired with nadir in the RT+ADT and ADT alone groups. Increasing two or more consecutive PSA values of > 0.2 ng/mL in RP group is defined as recurrence. Kaplan-Meier was used for survival analysis.
Results: The 5-year progression-free survival rate in RP, RT+ADT and ADT alone group was 58%, 53%, 58%. And overall survival rate was 100%, 48%, 55%, respectively. There’s significant difference of overall survival between RP and ADT alone group (P=0.035). But there is no significance in RP and RT+ADT group, (P= 0.09). No statistical significance of progression-free survival between RP, RT+ADT and ADT group.
RP showed better 5-year overall survival but not progression free survival to RT+ADT and ADT alone in Taiwan.