- In patients with high-grade prostate cancer and low PSA levels, radical prostatectomy (RP) improves OS vs external beam radiotherapy (EBRT)±brachytherapy (BT).
- Cancer-specific mortality (CSM) with RP was similar to EBRT+BT but significantly lower vs EBRT.
Why this matters
- No standard treatment exists for these patients.
- EBRT+BT can be an alternative option in patients aged >70 years or with PSA ≤2.5 ng/mL.
- 9114 patients with prostate cancer with PSA ≤10 ng/mL and Gleason score 8-10 received RP (n=4175), EBRT (n=4114), or EBRT+BT (n=825).
- Funding: National Natural Science Foundation of China.
- Median follow-up duration, 47 months.
- Compared with RP:
- OS was worse with EBRT (aHR, 3.36; P<.001 p=".002).</li">
- CSM risk was higher with EBRT (aHR, 2.46; P=.001).
- Risk for CSM was not significantly different with EBRT+BT (aHR, 1.31; P=.485).
- patients aged >70 years: aHR, 1.84 (P=.071) and 1.63 (P=.266), respectively; or
- patients with PSA levels ≤2.5 ng/mL: aHR, 0.58 (P=.556) and 1.27 (P=.774), respectively.
- Retrospective study.