Prostate cancer: ablation yields poor survival vs radiotherapy

  • Zhou X & al.
  • Sci Rep
  • 4 Jun 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Radiotherapy is associated with superior survival outcomes in patients with low- and intermediate-risk localized prostate cancer vs focal laser ablation (FLA).

Why this matters

  • FLA showed encouraging short-term oncologic and functional outcomes, but information regarding long-term survival is lacking.
  • The current findings suggest radiotherapy should be preferred over FLA in the management of patients with low-/intermediate-risk prostate cancer.

Study design

  • 93,469 patients with low- and intermediate-risk prostate cancer from the Surveillance, Epidemiology, and End Results program received laser ablation or radiotherapy between 2004 and 2015.
  • Funding: National Key Research and Development Program of China; others.

Key results

  • FLA was associated with significantly worse OS vs radiotherapy:
    • aHR, 1.49 (P<.001>
  • No difference was observed in cancer-specific mortality between the 2 treatments:
    • aHR, 1.57 (P=.237).
  • In propensity score-matched analysis of 2568 patients treated with radiotherapy and 428 treated with FLA:
    • OS was significantly worse with FLA:
      • HR, 1.50 (P=.001).
    • No difference was seen in cancer-specific survival:
      • HR, 1.48 (P=.336).

Limitations

  • Retrospective.