TY - JOUR
T1 - Long-term results of a randomized trial for the treatment of stages B2 and C prostate cancer
T2 - Radical prostatectomy versus external beam radiation therapy with a common endocrine therapy in both modalities
AU - Akakura, Koichiro
AU - Isaka, Shigeo
AU - Akimoto, Susumu
AU - Ito, Haruo
AU - Okada, Kiyoki
AU - Hachiya, Takahiko
AU - Yoshida, Osamu
AU - Arai, Yoichi
AU - Usami, Michiyuki
AU - Kotake, Toshihiko
AU - Tobisu, Ken Ichi
AU - Ohashi, Yasuo
AU - Sumiyoshi, Yoshiteru
AU - Kakizoe, Tadao
AU - Shimazaki, Jun
N1 - Funding Information:
This study was supported by grants from the Ministry of Health and Welfare, Japan (1989 to 1991, principal investigator: T. Kakizoe; 1991 to 1993, principal investigator: J. Shimazaki).
Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 1999/8
Y1 - 1999/8
N2 - Objectives. To improve the treatment of locally advanced prostate cancer (Stages B2 and C), a prospective randomized trial was conducted to compare radical prostatectomy versus external beam radiotherapy with the combination of endocrine therapy in both modalities. Methods. One hundred patients were enrolled and 95 were evaluated. Forty-six patients underwent radical prostatectomy with pelvic lymph node dissention, and 49 were treated with radiation by linear accelerator with 40 to 50 Gy to the whole pelvis and a 20-Gy boost to the prostatic area. For all patients, endocrine therapy was initiated 8 weeks before surgery or radiation, and continued thereafter. The living patients were asked to respond to a quality-of-life questionnaire. Results. The follow-up period ranged from 6.0 to 94.4 months (median 58.5). The progression-free and cause-specific survival rates at 5 years were 90.5% and 96.6% in the surgery group and 81.2% and 84.6% in the radiation group, respectively. The surgery group had better progression-free and cause- specific survival rates (P = 0.044 and 0.024, respectively). More patients in the surgery group complained of urinary incontinence. The questionnaire revealed that quality of life was less disturbed in the radiation group. Conclusions. Radical prostatectomy combined with endocrine therapy may contribute to the survival benefit of patients with locally advanced prostate cancer. External beam radiotherapy in combination with endocrine therapy can be used in selected patients because of its low morbidity.
AB - Objectives. To improve the treatment of locally advanced prostate cancer (Stages B2 and C), a prospective randomized trial was conducted to compare radical prostatectomy versus external beam radiotherapy with the combination of endocrine therapy in both modalities. Methods. One hundred patients were enrolled and 95 were evaluated. Forty-six patients underwent radical prostatectomy with pelvic lymph node dissention, and 49 were treated with radiation by linear accelerator with 40 to 50 Gy to the whole pelvis and a 20-Gy boost to the prostatic area. For all patients, endocrine therapy was initiated 8 weeks before surgery or radiation, and continued thereafter. The living patients were asked to respond to a quality-of-life questionnaire. Results. The follow-up period ranged from 6.0 to 94.4 months (median 58.5). The progression-free and cause-specific survival rates at 5 years were 90.5% and 96.6% in the surgery group and 81.2% and 84.6% in the radiation group, respectively. The surgery group had better progression-free and cause- specific survival rates (P = 0.044 and 0.024, respectively). More patients in the surgery group complained of urinary incontinence. The questionnaire revealed that quality of life was less disturbed in the radiation group. Conclusions. Radical prostatectomy combined with endocrine therapy may contribute to the survival benefit of patients with locally advanced prostate cancer. External beam radiotherapy in combination with endocrine therapy can be used in selected patients because of its low morbidity.
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U2 - 10.1016/S0090-4295(99)00106-5
DO - 10.1016/S0090-4295(99)00106-5
M3 - Article
C2 - 10443731
AN - SCOPUS:0032787203
VL - 54
SP - 313
EP - 318
JO - Urology
JF - Urology
SN - 0090-4295
IS - 2
ER -