Long-term results of a randomized trial for the treatment of stages B2 and C prostate cancer: Radical prostatectomy versus external beam radiation therapy with a common endocrine therapy in both modalities

Koichiro Akakura, Shigeo Isaka, Susumu Akimoto, Haruo Ito, Kiyoki Okada, Takahiko Hachiya, Osamu Yoshida, Yoichi Arai, Michiyuki Usami, Toshihiko Kotake, Ken Ichi Tobisu, Yasuo Ohashi, Yoshiteru Sumiyoshi, Tadao Kakizoe, Jun Shimazaki

Research output: Contribution to journalArticlepeer-review

64 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)313-318
Number of pages6
JournalUrology
Volume54
Issue number2
DOIs
Publication statusPublished - 1999 Aug
Externally publishedYes

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Long-term results of a randomized trial for the treatment of stages B2 and C prostate cancer: Radical prostatectomy versus external beam radiation therapy with a common endocrine therapy in both modalities'. Together they form a unique fingerprint.

Cite this