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dc.contributor.authorMarkovina, S.
dc.contributor.authorMeeks, M.W.
dc.contributor.authorBadiyan, S.
dc.date.accessioned2019-05-21T18:56:26Z
dc.date.available2019-05-21T18:56:26Z
dc.date.issued2018
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85042351511&doi=10.1016%2fj.adro.2017.12.001&partnerID=40&md5=dab6000d2ce30ffbf48d62f1e5ff38d3
dc.identifier.urihttp://hdl.handle.net/10713/9308
dc.description.abstractPurpose: For high-risk prostate cancer (HR-PCa) in men with a life expectancy of at least 10 years, the National Comprehensive Cancer Network recommends radiation therapy (RT) plus androgen deprivation therapy (ADT) with category 1 evidence or radical prostatectomy (RP) as an acceptable initial therapy. Randomized evidence regarding which therapy is optimal for disease control is lacking for men with HR-PCa. We performed a propensity-score-matched comparison of outcomes for men with localized HR-PCa treated with primary RT or RP. Methods and materials: The medical records of patients with localized HR-PCa who were treated at our institution between 2002 and 2011 were reviewed. Patient and disease characteristics, treatment details, and outcomes were collected. A combination of nearest-neighbor propensity score matching on age, Adult Comorbidity Evaluation-27 comorbidity index, prostate-specific antigen, biopsy Gleason scores, and clinical T-stage as well as exact matching on prostate-specific antigen, biopsy Gleason scores, and clinical T-stage was performed. Outcomes were measured from diagnosis. Multivariate Cox proportional hazards regression was used to compare metastasis-free and overall survival. Results: A total of 246 patients were identified with 62 propensity-score-matched pairs. ADT was administered to 6.5% and 80.6% of patients receiving RP and RT, respectively. Five-year rates of metastasis for RP and RT were 33% and 8.9%, respectively (P =.003). Overall survival was not different. Delay of salvage therapy was longer for patients undergoing primary RT (P <.001). Findings were similar when only those patients who did not receive ADT were compared. Conclusions: At our institution, treatment with primary RT resulted in superior metastasis-free survival over RP. This was not accompanied by an improvement in OS. Copyright 2017 The Authorsen_US
dc.description.urihttps://dx.doi.org/10.1016/j.adro.2017.12.001en_US
dc.language.isoen-USen_US
dc.publisherElsevier Incen_US
dc.relation.ispartofAdvances in Radiation Oncology
dc.subject.meshComparative Effectiveness Researchen_US
dc.subject.meshProstate Neoplasms--therapyen_US
dc.subject.meshRisk Assessmenten_US
dc.subject.meshTreatment Outcomeen_US
dc.titleSuperior metastasis-free survival for patients with high-risk prostate cancer treated with definitive radiation therapy compared to radical prostatectomy: A propensity score-matched analysisen_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.adro.2017.12.001


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