Local therapy and improved survival in advanced prostate cancer

The authors aimed to compare outcomes after local therapy versus no local therapy in men with advanced prostate cancer (cancer that has spread outside the prostate gland).

The authors concluded that local therapy resulted in better outcomes when compared to no local therapy. They also concluded that in patients who received local therapy, men who received surgery had a lower mortality rate than men who received radiation therapy.

The standard of care in advanced prostate cancer is hormone therapy (targets the male sex hormones active in prostate cancer, such as testosterone) with no local therapy. Local therapy is a treatment directed specifically at the prostate or surrounding area. This can include surgery (removal of the prostate gland) and radiation therapy (focusing beams of radiation at the tumor site to kill the cancer cells). The Gleason score can be used before or after treatment to determine how different the cancer cells look from normal cells and the likelihood that they will spread. The lower the number, the less likely the tumor is to spread.

Local therapy has been seen to improve survival in men with advanced prostate cancer but further research is needed to validate this.

The aim of this study was to determine outcome after local therapy compared to no local therapy in men with advanced prostate cancer.

13,692 men were used in this study. 13,218 men in group 1 did not receive local therapy. 474 men in group 2 received local therapy (313 received surgery and 161 received radiation therapy). 

Patients in group 2 had a 60% reduced risk of cancer-related mortality compared to group 1. Patients in group 2 treated with surgery had a 41% reduced risk compared to those treated with radiation. Patients with lower Gleason scores and lower disease stage had the most improved outcome with local therapy.

The authors concluded that local therapy resulted in lower mortality rates when compared to no local therapy. They also concluded that in patients who received local therapy, men who received surgery had a lower mortality rate than men who received radiation therapy.

Discuss with your doctor whether some form of local therapy would be beneficial for you.