RP may offer survival benefit over other treatments in T4 disease

Survival rates appear to be better in patients with clinical T4 prostate cancer after radical prostatectomy than in patients receiving only radiation therapy or hormone therapy, according to a study by researchers at Emory University in Atlanta.

Researchers reviewed data from 1,093 patients over a 7-year period (1995-2001) from the Surveillance Epidemiology and End Results database. Post-diagnosis survival was examined in five treatment groups: prostatectomy either alone or in combination with other therapy, radiation therapy alone, hormone therapy alone, radiation therapy plus hormone therapy, and no treatment.

Investigators found that survival rates were lowest among patients who did not have any treatment and highest among patients who underwent surgery. They also found that the addition of radiation therapy or hormone therapy to surgery did not increase survival.

Among treatment types, researchers found the differences in survival more noticeable in a relatively small subset of patients with regional lymph node extension. A modest, “but not significant” improvement in survival occurred in all other patients after combination therapy of radiation and hormone, added the authors, led by Peter A.S. Johnstone, MD.

Study results were published in Cancer (2006; 106:2603-9).