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 Journal Article


Authors: Grimm, P.; Billiet, I.; Bostwick, D.; Dicker, A. P.; Frank, S.; Immerzeel, J.; Keyes, M.; Kupelian, P.; Lee, W. R.; MacHtens, S.; Mayadev, J.; Moran, B. J.; Merrick, G.; Millar, J.; Roach, M.; Stock, R.; Shinohara, K.; Scholz, M.; Weber, E.; Zietman, A.; Zelefsky, M.; Wong, J.; Wentworth, S.; Vera, R.; Langley, S.
Article Title: 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
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. © 2012 BJU INTERNATIONAL.
Keywords: cancer survival; disease-free survival; survival rate; intensity modulated radiation therapy; cancer risk; comparative study; outcome assessment; neoplasm staging; prostate specific antigen; progression free survival; radiotherapy; risk factors; high risk patient; prostate cancer; prostate-specific antigen; prostatic neoplasms; systematic review; prostatectomy; disease progression; high intensity focused ultrasound; brachytherapy; radical prostatectomy; protons; robotics; external beam radiotherapy; androgen deprivation therapy; cryotherapy; intermediate risk patient; proton therapy; low risk patient; biochemical-free progression
Journal Title: BJU International
Volume: 109
Issue: Suppl. 1
ISSN: 1464-4096
Publisher: Wiley Blackwell  
Date Published: 2012-02-01
Start Page: 22
End Page: 29
Language: English
DOI: 10.1111/j.1464-410X.2011.10827.x
PROVIDER: scopus
PUBMED: 22239226
DOI/URL:
Notes: --- - "Export Date: 1 March 2012" - "CODEN: BJINF" - "Source: Scopus"
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  1. Michael J Zelefsky
    611 Zelefsky