Oncologic Outcomes of Radical Prostatectomy and High-Dose Intensity-Modulated Radiotherapy with Androgen-Deprivation Therapy for Relatively Young Patients with Unfavorable Intermediate-Risk Prostate Adenocarcinoma

PURPOSE: To estimate the oncologic outcomes of radical prostatectomy (RP) and high-dose intensity-modulated radiotherapy (IMRT) with short-term androgen-deprivation therapy (ADT) in relatively young men with unfavorable intermediate-risk prostate cancer, as defined by the National Comprehensive Cancer Network (NCCN-UIR-PC).

PATIENTS AND METHODS: We enrolled relatively young men (≤65 years) from the Taiwan Cancer Registry who had been diagnosed as having NCCN-UIR-PC and who had received RP or high-dose IMRT (at least ≥72 Gy) with short-term ADT (4-6 months). After propensity score matching of the confounders, Cox proportional regression was used to model the time from the index date (i.e., date of diagnosis) to all-cause death, biochemical failure (BF), locoregional recurrence (LRR), and distant metastasis (DM).

RESULTS: The corresponding adjusted hazard ratios (95% confidence intervals) of the risk of all-cause death, BF, LRR, and DM were 2.76 (1.36-5.60, p = 0.0050), 2.74 (1.72-4.84, p < 0.0001), 1.28 (1.09-1.90, p = 0.0324), and 2.11 (1.40-4.88, p = 0.0052), respectively.

CONCLUSIONS: RP is superior to high-dose IMRT with short-term ADT in terms of oncologic outcomes for relatively young men with UIR-PC.