Long-term outcomes and prognostic factors in patients treated with intraoperatively planned prostate brachytherapy.
OBJECTIVE
Evaluate outcomes and prognostic factors in men with localized prostate cancer.


METHODS
A total of 3760 patients have undergone prostate seed implantation at our institution. This review is of our initial 304 consecutive patients treated before January 30, 2001. A total of 124 patients were treated with (125)I implant monotherapy and 180 with (103)Pd implant combined with 45-Gy external beam radiation therapy.


RESULTS
The median followup was 10.3 years. A 10-year biochemical control for low risk (LR) was 98% , intermediate risk (IR) 94%, high risk (HR) 78%, and HR with one HR factor 88% (p < 0.001); cause-specific survival was 99%, 98%, and 84% for LR, IR, and HR, respectively (p < 0.001); No significant difference in outcome was seen for LR and IR patients (p > 0.3). On multivariate analysis, only pretreatment PSA, Gleason score, and T-stage were significant for biochemical control. Most biochemical failures occurred within 5 years (93%).


CONCLUSIONS
With a minimum followup of 10 years, results are excellent and do not differ for LR or IR prostate cancer patients. HR patients are a very heterogeneous group, and excellent results can still be achieved for HR patients with only one HR feature.
Florida Center for Prostate Care, Jacksonville, FL, USA. cvargas@frogdocs.com
Carlos
C
Vargas
Douglas
D
Swartz
Apoorva
A
Vashi
Mark
M
Blasser
Ali
A
Kasareian
Jamie
J
Cesaretti
Kathleen
K
Kiley
Mitchell
M
Terk
D000368:Aged; D001918:Brachytherapy / Q000401:mortality*; D003131:Combined Modality Therapy / Q000401:mortality; D005431:Florida / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007432:Intraoperative Period; D008137:Longitudinal Studies; D008297:Male; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000628:therapy*; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome