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

Chih-Chen Hsu¹, Chun-You Chen², Yu-Ching Wen^{1, 3}, , Ke-Hsun Lin^{1, 3},Yung-Wei Lin^{1, 3},Chung-Chi Liu^1, Liang-Ming Lee^{1, 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.