Oncological outcomes of patients with ductal adenocarcinoma of the prostate receiving radical prostatectomy or radiotherapy

作     者：Mengzhu Liu Kun Jin Shi Qiu Pengyong Xu Mingming Zhang Wufeng Cai Xiaonan Zheng Lu Yang Qiang Wei 

作者机构：Institute of UrologyDepartment of UrologyWest China HospitalSichuan UniversityChengduChina Center of Biomedical Big DataWest China HospitalSichuan UniversityChengduChina Institute of UrologyDepartment of Urologythe First People’s HospitalYantaiChina 

出 版 物：《Asian Journal of Urology》 (亚洲泌尿外科杂志（英文）)

年 卷 期：2021年第8卷第2期

页      面：227-234页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：supported by the National Key Research and Development Program of China(Grant No.SQ2017YFC0908003) National Natural Science Foundation of China(Grant No.81702536,81770756) the Sichuan Science and Technology Program(2017HH0063) China Postdoctoral Science Foundation(2017M612971) Post-Doctor Research Project,West China Hospital,Sichuan University(2018HXBH085) National Clinical Research Center for Geriatrics,West China Hospital,Sichuan University(Z2018C01). 

主　　题：Ductal adenocarcinoma of the prostate Cancer specific mortality Overall mortality Radical prostatectomy Radiotherapy 

摘      要：Objective:To evaluate the oncological outcomes of ductal adenocarcinoma of the prostate(DAC)managed with radical prostatectomy(RP)or radiotherapy(RT)and optimize the proper treatment modality to DAC comprehensively.Methods:The cohorts included a total of 528 patients from the Surveillance,Epidemiology and End Results(SEER)database,354 receiving RP and 174 receiving RT.Cox proportional hazards regressions were performed to assess cancer specific mortality(CSM)and overall mortality(OM)between treatment groups.A competing risk analysis was further conducted.Subgroup analyses by age and level of prostate-specific antigen(PSA)were performed.Propensity score matching was implemented.Results:Patients managed with RP had lower risks of CSM and OM compared with RT(before matching:Hazard ratio[HR]=0.24,95%confidence interval[CI]0.13-0.47 and HR=0.26,95%CI 0.17-0.40,respectively;after matching:HR=0.18,95%CI 0.04-0.82 and HR=0.28,95%CI 0.11-0.70,accordingly).Subgroup analyses demonstrated that patients in the middle tertile of the age or with lower tertile PSA level managed with RP took lower risks of OM signif­icantly(HR=0.18,95%CI 0.06-0.57,p0.01 and HR=0.17,95%CI 0.06-0.54,p0.01).Conclusion:Among patients with DAC,treatment with RP was associated with better survival outcomes in comparison with RT.Patients with DAC in the middle tertile of the age and with lower tertile PSA level benefited the most from RP.