Experience with radical prostatectomy and radiation therapy for localized prostate cancer at a Veterans Affairs Medical Center.
We assessed the actuarial survival of 357 patients with localized prostate cancer who were treated with radical prostatectomy or radiation therapy at a Veterans Affairs Medical Center between 1980 and 1991 and who were followed for a median of 59 months. During this period patients with clinical stages A2 and B tumors who had an anticipated life expectancy of 10 years or greater were generally treated with surgery. Patients with stages A2 and B tumors who were not candidates for surgery and those with stage C tumors were generally treated with radiation therapy. There were no significant differences among the cause specific, clinical disease-free and prostate specific antigen disease-free survival curves of patients with stages A2 and B tumors who were treated with radical prostatectomy (138) or radiation therapy (138) but the all cause and metastases-free survival curves favored the surgery group (p < 0.000001 and 0.046, respectively). There was no significant difference between the all cause survival curves of the patients with stages A2 and B tumors and of 81 patients with stage C tumors who were treated with radiation therapy. However, the cause specific survival curves favored the patients with stages A2 and B tumors (p = 0.000007). This study demonstrates that there is a high risk of death from co-morbidities in a hospital based population of American veterans with localized prostate cancer who are not candidates for radical prostatectomy.
Division of Urology, University of Mississippi Medical Center, Jackson.
J E
JE
Fowler
N T
NT
Braswell
P
P
Pandey
L
L
Seaver
D000206:Actuarial Analysis; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome