title: [Comparison of the Biochemical Recurrence risk between Radical Prostatectomy and Brachytherapy in the treatment of low- and intermediate-risk prostate cancer].
abstract: OBJECTIVE
  To evaluate the results of patients treated with Radical Prostatectomy (RP) and Brachytherapy for low- and intermediate-risk localized prostate cancer and to determine the Biochemical Recurrence (BCR) risk according to the treatment performed.
  
  
  METHODS
  The study included 129 patients treated with iodine-125 seeds Brachytherapy, 98 patients treated with Laparoscopic RP (LRP), and 61 patients treated with Robotic RP (RRP) at our institution between December 1999 and January 2010, who had a low-risk disease according to D'Amico criteria (PSA <10 ng/mL, Gleason < or = 6, cT1c-T2a), or an intermediate-risk disease (PSA = or >10 and < 20 ng/mL, Gleason = 7, cT2b), but with a tumor burden of up to 30%. Follow-up was conducted with PSA at 1, 3, and 6 months, and then every six months. As for Brachytherapy, annual digital rectal examinations were also performed. A PSA level increase of 2 ng/mL above the nadir in Brachytherapy (confirmed in 2 cases) and a PSA value greater than 0.2 ng/mL after RP were considered BCR.
  
  
  RESULTS
  Overall mean follow-up was 60.5 months (R:1-152), with a mean time for BCR of 51.7 months (R:1-138). Estimated 5-year Biochemical Recurrence-free Survival (BCRFS) in patients with D'Amico low-risk was 85.7%, 77.2% and 90.7% (p 0.336), while for intermediate-risk it was 75.8%, 68.1% and 65.1% (p 0.114), for Brachytherapy, LRP and RRP respectively. In the univariate analysis, the Gleason score 7, a clinical stage T2b, and a D'Amico intermediate-risk were associated with an increased BCR risk, and treatment with Brachytherapy was associated with a decreased BCR risk, all these being statistically significant. In the multivariate analysis, only the Gleason score 7 was significant; treatment with LRP, RRP or Brachytherapy was not associated with a greater BCR risk.
  
  
  CONCLUSIONS
  Brachytherapy and Laparoscopic or Robotic Radical Prostatectomy showed no difference in terms of Biochemical Recurrence risk in patients treated for low-risk or intermediate-risk tumors, with low tumor volume.
authors.affiliation: Service of Urology. Hospital Italiano de Buenos Aires. Argentina.
authors.forename: Pablo F
authors.initials: PF
authors.lastname: Martínez
authors.affiliation: Service of Urology. Hospital Italiano de Buenos Aires. Argentina.
authors.forename: Diego F
authors.initials: DF
authors.lastname: Belisle
authors.affiliation: Service of Urology. Hospital Italiano de Buenos Aires. Argentina.
authors.forename: Christian
authors.initials: C
authors.lastname: Cristallo
authors.affiliation: Service of Urology. Hospital Italiano de Buenos Aires. Argentina.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Tobía
authors.affiliation: Service of Urology. Hospital Italiano de Buenos Aires. Argentina.
authors.forename: Oscar
authors.initials: O
authors.lastname: Damia
authors.affiliation: Service of Urology. Hospital Italiano de Buenos Aires. Argentina.
authors.forename: Wenceslao
authors.initials: W
authors.lastname: Villamil
authors.affiliation: Service of Urology. Hospital Italiano de Buenos Aires. Argentina.
authors.forename: Carlos R
authors.initials: CR
authors.lastname: Giudice
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000453:epidemiology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D017430:Prostate-Specific Antigen