title: Brachytherapy and radical prostatectomy in patients with early prostate cancer.
abstract: OBJECTIVE
  this study analyzes the survival of prostate cancer patients cared for at a hospital in Minas Gerais, Brazil according to one of the following treatments: iodine-125 seed implantation or radical prostatectomy. From January 2002 to December 2005, 129 patients underwent either brachytherapy (64 patients) or surgery (65 patients).
  
  
  METHODS
  all had prostate-specific antigen, Gleason scores and clinical stage recorded prior to treatment. Biochemical relapse was defined as prostate-specific antigen (PSA)>0.4 ng/mL for radical prostatectomy, and any elevation equal or higher than 2 ng/mL over the PSA nadir for implanted patients. To analyze the effect of treatment on biochemical recurrence-free survival (BRFS), Kaplan-Meier curves and Cox regression were generated. Mean follow-up time was 56.1 months for patients with the implant, and 26.6 months for those operated on. BRFS in 5 years was 69% (95% CI: 58.18-77.45) for the whole cohort.
  
  
  CONCLUSIONS
  when stratified according to treatment, survival of patients who had undergone brachytherapy (79.70%) was higher to those operated on (44.30%; p value= 0.0056). Upon multivariate analysis, independent predictors were iPSA (HR: 2.91, 95% CI: 1,32-6,42), Gleason score (HR: 2.18, 95% CI: 1,00-4,81) and treatment modality (HR: 2.61, 95% CI: 1.18-5,75). Risk of biochemical failure was higher with surgery than brachytherapy, which may be related to the failure criteria adopted, which is different for each therapy, as well as the high rate of histological progression between preoperative prostate biopsy and surgical specimen.
  
  
  CONCLUSIONS
  it was found that brachytherapy is a good therapeutic option for low risk prostate cancer.
authors.affiliation: Oncology Service, Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Adriana Souza Sérgio
authors.initials: AS
authors.lastname: Ferreira
authors.affiliation: Department of Collective Health, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Maximiliano Ribeiro
authors.initials: MR
authors.lastname: Guerra
authors.affiliation: Department of Surgery, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Humberto Elias
authors.initials: HE
authors.lastname: Lopes
authors.affiliation: Radiotherapy Service, Hospital Ascomcer, Juiz de Fora, MG, Brazil.
authors.forename: U-Thant Mendonça
authors.initials: UT
authors.lastname: Lima
authors.affiliation: Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Yara Abrão
authors.initials: YA
authors.lastname: Vasconcelos
authors.affiliation: Department of Collective Health, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Maria Teresa Bustamante
authors.initials: MT
authors.lastname: Teixeira
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000628:therapy*; D018570:Risk Assessment; D016019:Survival Analysis
chemical_list: D007457:Iodine Radioisotopes; D017430:Prostate-Specific Antigen