Comparing survival for surgery versus radiation therapy in patients with prostate cancer

This study compared survival rates for patients with prostate cancer who were treated with either surgery to remove the prostate (radical prostatectomy) or radiation therapy (external beam radiotherapy). 

The prostate is a gland in the reproductive system of men, which is found under the urinary bladder. In a normal physical exam, the prostate is felt by the doctor with a finger during a rectal exam. Cancer of the prostate is often very slow growing, but there are some types which are more dangerous, and need to be treated before they move on to other parts of the body. Treatment for prostate cancer includes surgery, radiotherapy, chemotherapy or hormone therapy. The more aggressive the treatment is, patients will have less risk that the cancer with return. Radical prostatectomy (RP) is surgery to remove the prostate gland and some tissues around it to make sure that the cancer did not spread beyond the prostate. External beam radiotherapy (EBRT) is a type of radiation therapy that uses a radiation (x-ray) beam directed at the cancer to kill cancer cells. 

3533 men diagnosed with prostate cancer participated in this study. All patients had localized (confined) prostate cancer and were treated with either RP or EBRT in the first year after diagnosis. Patients were followed for 15 years and the main parameters evaluated were overall survival or OS (defined as the percentage of patients who have survived for a certain period of time) and disease-specific survival or DSS (defined as the percentage of patients who have not died from prostate cancer for a certain period of time). The men who had RP had a 40% higher OS and a 65% higher DSS compared to patients treated with EBRT. Younger men (aged 55-64) seemed to have even better outcomes after RP, with a 64% greater OS and a 79% higher DSS. 

In summary, RP was found to offer better survival rates compared to EBRT in patients with prostate cancer. 

Treatment for these patients was done more than 15 years ago and surgical and radiological techniques have changed over time.