Evaluation of Cancer Specific Mortality with Surgery versus Radiation as Primary Therapy for Localized High Grade Prostate Cancer in Men Younger Than 60 Years

No AccessJournal of UrologyAdult Urology1 Jan 2019Evaluation of Cancer Specific Mortality with Surgery versus Radiation as Primary Therapy for Localized High Grade Prostate Cancer in Men Younger Than 60 Years Hubert Huang, Stefano Muscatelli, Michael Naslund, Shahed N. Badiyan, Adeel Kaiser, and Mohummad Minhaj Siddiqui Hubert HuangHubert Huang Division of Urology, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland More articles by this author , Stefano MuscatelliStefano Muscatelli Division of Urology, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland More articles by this author , Michael NaslundMichael Naslund Division of Urology, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland More articles by this author , Shahed N. BadiyanShahed N. Badiyan Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland More articles by this author , Adeel KaiserAdeel Kaiser Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland More articles by this author , and Mohummad Minhaj SiddiquiMohummad Minhaj Siddiqui *Correspondence: Division of Urology, University of Maryland Medical Center, 29 South Greene St., Suite 500, Baltimore, Maryland 21201 (telephone: 410-328-6422; FAX: 410-328-0595; e-mail: E-mail Address: [email protected]). Division of Urology, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.07.049AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The optimal primary treatment of localized high grade prostate cancer in younger men remains controversial. The objective of this project was to compare the impact of initial radical prostatectomy vs radiation therapy on survival outcomes in young men less than 60 years old with high grade prostate cancer. Materials and Methods: We retrospectively analyzed the records of men younger than 60 years in the SEER (Surveillance, Epidemiology and End Results) database who underwent initial surgery or radiation therapy of high grade (Gleason score 8 or greater) localized (N0M0 TNM stage) prostate cancer from 2004 to 2012. Univariate and multivariate Cox proportional hazards regression models were used to examine prostate cancer specific and overall mortality. Results: A total of 2,228 men were identified, of whom 1,459 (65.5%) underwent initial surgery and had a median followup of 43 months and 769 (34.5%) underwent initial external beam radiation therapy with or without brachytherapy and had a median followup of 44 months. On multivariate analysis initial treatment with surgery was associated with improved prostate cancer specific and overall mortality compared with initial radiation treatment (HR 0.37, 95% CI 0.19–0.74, p = 0.005 vs HR 0.41, 95% CI 0.24–0.70, p = 0.001) when controlling for age, biopsy Gleason score, T stage and prostate specific antigen. Conclusions: Our data showed significant survival differences in young men treated initially with surgery vs external beam radiation therapy of high grade prostate cancer. 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Google Scholar The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. No direct or indirect commercial incentive associated with publishing this article. © 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byGuo B and Liu M (2021) Evaluation of Cancer Specific Mortality with Surgery versus Radiation as Primary Therapy for Localized High Grade Prostate Cancer in Men Younger Than 60 Years. Letter.Journal of Urology, VOL. 205, NO. 5, (1530-1531), Online publication date: 1-May-2021. Volume 201Issue 1January 2019Page: 120-128Supplementary Materials Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.Keywordsprostatic neoplasmsprostatectomybrachytherapySEER ProgramradiotherapyMetricsAuthor Information Hubert Huang Division of Urology, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland More articles by this author Stefano Muscatelli Division of Urology, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland More articles by this author Michael Naslund Division of Urology, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland More articles by this author Shahed N. Badiyan Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland More articles by this author Adeel Kaiser Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland More articles by this author Mohummad Minhaj Siddiqui Division of Urology, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland *Correspondence: Division of Urology, University of Maryland Medical Center, 29 South Greene St., Suite 500, Baltimore, Maryland 21201 (telephone: 410-328-6422; FAX: 410-328-0595; e-mail: E-mail Address: [email protected]). More articles by this author Expand All The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. No direct or indirect commercial incentive associated with publishing this article. Advertisement PDF downloadLoading ...