title: Long-term oncological outcome in men with T3 prostate cancer: radical prostatectomy versus external-beam radiation therapy at a single institution.
abstract: BACKGROUND
  This study was designed to compare the long-term oncological outcome of patients with clinical T3 (cT3) prostate cancer (PCA) treated with either radical prostatectomy (RP) or external-beam radiation therapy (EBRT) and to identify predictors of oncological outcomes.
  
  
  METHODS
  A total of 231 patients with cT3 PCA underwent either RP (n = 112) or EBRT (n = 119). Local progression-free (LPFS), distant metastasis-free (DMFS), cancer-specific (CSS), and overall survival curves were generated with the Kaplan-Meier method, and the differences in survival rates between the two groups were assessed with a log-rank test. Cox proportional stepwise multivariate analysis was used to assess the association of variables to the oncological outcomes.
  
  
  RESULTS
  The median follow-up of the RP and EBRT groups was 93 and 85 months, respectively (p = 0.004).The 10-year LPFS, DMFS, and CSS rates were not statistically different between the two groups (90.2, 73.9, and 93.7 % in the RP group and 82.7, 88.2, and 85.1 % in the EBRT group; p = 0.25, 0.10, and 0.10, respectively). The Cox proportional multivariate analysis revealed that clinical T3b (cT3b) (p = 0.001) and a biopsy Gleason score of 7-10 (p = 0.043) were significant predictors of cancer-specific mortality and that cT3b was also a significant predictor of local progression and all-cause mortality.
  
  
  CONCLUSIONS
  In cT3 PCA, both RP and EBRT provide an excellent long-term oncological outcome. cT3b was the strongest predictor of oncological outcome for the patients with locally advanced PCA who underwent the definitive therapy.
authors.affiliation: Department of Urology, Japanese Foundation for Cancer Research, Cancer Institute Hospital, 3-8-31 Ariake, Koto, Tokyo, 135-8550, Japan, shinya.yamamoto@jfcr.or.jp.
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Satoru
authors.initials: S
authors.lastname: Kawakami
authors.forename: Junji
authors.initials: J
authors.lastname: Yonese
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Fujii
authors.forename: Shinji
authors.initials: S
authors.lastname: Urakami
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kitsukawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Masuda
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Takuyo
authors.initials: T
authors.lastname: Kozuka
authors.forename: Masahiko
authors.initials: M
authors.lastname: Oguchi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kohno
authors.forename: Iwao
authors.initials: I
authors.lastname: Fukui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading / Q000379:methods; D011467:Prostate / Q000473:pathology / Q000528:radiation effects / Q000601:surgery; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome