Abstract
A large number of studies have been conducted on the primary therapy of prostate cancer but very few randomized controlled trials have been conducted. The comparison of outcomes from individual studies involving surgery (radical prostatectomy or robotic radical prostatectomy), external beam radiation (EBRT) (conformal, intensity modulated radiotherapy, protons), brachytherapy, cryotherapy or high intensity focused ultrasound remains problematic due to the non-uniformity of reporting results and the use of varied disease outcome endpoints. Technical advances in these treatments have also made long-term comparisons difficult. The Prostate Cancer Results Study Group was formed to evaluate the comparative effectiveness of prostate cancer treatments. This international group conducted a comprehensive literature review to identify all studies involving treatment of localized prostate cancer published during 2000-2010. Over 18 000 papers were identified and a further selection was made based on the following key criteria: minimum/median follow-up of 5 years; stratification into low-, intermediate- and high-risk groups; clinical and pathological staging; accepted standard definitions for prostate-specific antigen failure; minimum patient number of 100 in each risk group (50 for high-risk group). A statistical analysis (standard deviational ellipse) of the study outcomes suggested that, in terms of biochemical-free progression, brachytherapy provides superior outcome in patients with low-risk disease. For intermediate-risk disease, the combination of EBRT and brachytherapy appears equivalent to brachytherapy alone. For high-risk patients, combination therapies involving EBRT and brachytherapy plus or minus androgen deprivation therapy appear superior to more localized treatments such as seed implant alone, surgery alone or EBRT. It is anticipated that the study will assist physicians and patients in selecting treatment for men with newly diagnosed prostate cancer.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 22-29 |
| Number of pages | 8 |
| Journal | BJU International |
| Volume | 109 |
| Issue number | SUPPL. 1 |
| DOIs | |
| State | Published - Feb 2012 |
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Keywords
- biochemical-free progression
- brachytherapy
- cryotherapy
- prostate cancer
- protons
- radical prostatectomy
- radiotherapy
ASJC Scopus subject areas
- Urology
Cite this
Comparative analysis of prostate-specific antigen free survival outcomes for patients with low, intermediate and high risk prostate cancer treatment by radical therapy. Results from the Prostate Cancer Results Study Group. / Grimm, Peter; Billiet, Ignace; Bostwick, David; Dicker, Adam P.; Frank, Steven; Immerzeel, Jos; Keyes, Mira; Kupelian, Patrick; Lee, W. Robert; MacHtens, Stefan; Mayadev, Jyoti; Moran, Brian J.; Merrick, Gregory; Millar, Jeremy; Roach, MacK; Stock, Richard; Shinohara, Katsuto; Scholz, Mark; Weber, Ed; Zietman, Anthony; Zelefsky, Michael; Wong, Jason; Wentworth, Stacy; Vera, Robyn; Langley, Stephen.
In: BJU International, Vol. 109, No. SUPPL. 1, 02.2012, p. 22-29.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparative analysis of prostate-specific antigen free survival outcomes for patients with low, intermediate and high risk prostate cancer treatment by radical therapy. Results from the Prostate Cancer Results Study Group
AU - Grimm, Peter
AU - Billiet, Ignace
AU - Bostwick, David
AU - Dicker, Adam P.
AU - Frank, Steven
AU - Immerzeel, Jos
AU - Keyes, Mira
AU - Kupelian, Patrick
AU - Lee, W. Robert
AU - MacHtens, Stefan
AU - Mayadev, Jyoti
AU - Moran, Brian J.
AU - Merrick, Gregory
AU - Millar, Jeremy
AU - Roach, MacK
AU - Stock, Richard
AU - Shinohara, Katsuto
AU - Scholz, Mark
AU - Weber, Ed
AU - Zietman, Anthony
AU - Zelefsky, Michael
AU - Wong, Jason
AU - Wentworth, Stacy
AU - Vera, Robyn
AU - Langley, Stephen
PY - 2012/2
Y1 - 2012/2
N2 - A large number of studies have been conducted on the primary therapy of prostate cancer but very few randomized controlled trials have been conducted. The comparison of outcomes from individual studies involving surgery (radical prostatectomy or robotic radical prostatectomy), external beam radiation (EBRT) (conformal, intensity modulated radiotherapy, protons), brachytherapy, cryotherapy or high intensity focused ultrasound remains problematic due to the non-uniformity of reporting results and the use of varied disease outcome endpoints. Technical advances in these treatments have also made long-term comparisons difficult. The Prostate Cancer Results Study Group was formed to evaluate the comparative effectiveness of prostate cancer treatments. This international group conducted a comprehensive literature review to identify all studies involving treatment of localized prostate cancer published during 2000-2010. Over 18 000 papers were identified and a further selection was made based on the following key criteria: minimum/median follow-up of 5 years; stratification into low-, intermediate- and high-risk groups; clinical and pathological staging; accepted standard definitions for prostate-specific antigen failure; minimum patient number of 100 in each risk group (50 for high-risk group). A statistical analysis (standard deviational ellipse) of the study outcomes suggested that, in terms of biochemical-free progression, brachytherapy provides superior outcome in patients with low-risk disease. For intermediate-risk disease, the combination of EBRT and brachytherapy appears equivalent to brachytherapy alone. For high-risk patients, combination therapies involving EBRT and brachytherapy plus or minus androgen deprivation therapy appear superior to more localized treatments such as seed implant alone, surgery alone or EBRT. It is anticipated that the study will assist physicians and patients in selecting treatment for men with newly diagnosed prostate cancer.
AB - A large number of studies have been conducted on the primary therapy of prostate cancer but very few randomized controlled trials have been conducted. The comparison of outcomes from individual studies involving surgery (radical prostatectomy or robotic radical prostatectomy), external beam radiation (EBRT) (conformal, intensity modulated radiotherapy, protons), brachytherapy, cryotherapy or high intensity focused ultrasound remains problematic due to the non-uniformity of reporting results and the use of varied disease outcome endpoints. Technical advances in these treatments have also made long-term comparisons difficult. The Prostate Cancer Results Study Group was formed to evaluate the comparative effectiveness of prostate cancer treatments. This international group conducted a comprehensive literature review to identify all studies involving treatment of localized prostate cancer published during 2000-2010. Over 18 000 papers were identified and a further selection was made based on the following key criteria: minimum/median follow-up of 5 years; stratification into low-, intermediate- and high-risk groups; clinical and pathological staging; accepted standard definitions for prostate-specific antigen failure; minimum patient number of 100 in each risk group (50 for high-risk group). A statistical analysis (standard deviational ellipse) of the study outcomes suggested that, in terms of biochemical-free progression, brachytherapy provides superior outcome in patients with low-risk disease. For intermediate-risk disease, the combination of EBRT and brachytherapy appears equivalent to brachytherapy alone. For high-risk patients, combination therapies involving EBRT and brachytherapy plus or minus androgen deprivation therapy appear superior to more localized treatments such as seed implant alone, surgery alone or EBRT. It is anticipated that the study will assist physicians and patients in selecting treatment for men with newly diagnosed prostate cancer.
KW - biochemical-free progression
KW - brachytherapy
KW - cryotherapy
KW - prostate cancer
KW - protons
KW - radical prostatectomy
KW - radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=84862952700&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84862952700&partnerID=8YFLogxK
U2 - 10.1111/j.1464-410X.2011.10827.x
DO - 10.1111/j.1464-410X.2011.10827.x
M3 - Article
C2 - 22239226
AN - SCOPUS:84862952700
VL - 109
SP - 22
EP - 29
JO - BJU International
JF - BJU International
SN - 1464-4096
IS - SUPPL. 1
ER -