Prostate surgery versus radiation therapy: Comparing hospitalizations for treatment-related complications

This study compared the number of hospital admissions for treatment-related complications from prostate surgery and radiation therapy. Researchers reported higher rates of treatment-related hospitalizations following radiation therapy compared to surgery.

Localized prostate cancer is cancer that is confined to the prostate gland. Surgical removal of the prostate gland and radiation therapy are both common treatments for localized prostate cancer. Prostate surgery can involve open surgery (one large incision) or minimally invasive laparoscopic surgery (multiple small incisions). Radiation therapy involves directing high-energy rays at the tumor site to kill cancer cells. These can be directed from outside the body (external beam radiation therapy) or from a radiation source placed inside the prostate (brachytherapy). Advances in prostate surgery and radiation therapy have led to treatments being more effective and easier to tolerate. However, treatment-related complications requiring hospitalization may occur.

This study aimed to compare the number of treatment-related hospital admissions between prostate surgery and radiation therapy.

The records of 14,492 men treated with prostate surgery and 45,984 men treated with radiation therapy were analyzed. The rate of treatment-related hospital admissions was compared between treatment groups and to 52,026 control participants without prostate cancer. Patients were followed for an average of 5.6 years.

Compared to control participants, hospitalization rates were lower for men treated with prostate surgery and higher for men treated with radiation therapy. Overall, hospitalization was 83% more likely following radiation therapy compared to surgery.

For both treatment groups, hospital admissions peaked within two years of treatment. The average length of stay in hospital for men treated with radiation therapy was 2 days. The average hospital stay for those treated with surgery was 3 days. Radiation therapy significantly increased the chance of 1-day admissions 3.14-fold and admissions of 2 or more days by 58%.

7.2% of surgery patients later received additional treatment with radiation therapy. 0.2% of radiation-treated patients later underwent surgery. Additional treatment after primary radiation or surgery significantly increased rates of hospitalization. Patients who underwent surgery after radiation therapy had the highest rate of hospitalization.

Researchers concluded that treatment-related hospitalizations are more common following radiation therapy than surgery.

This analysis did not control for different types of prostate surgery and radiation therapy.