Surgery effective in patients with aggressive prostate cancer

Patients with the most aggressive forms of prostate cancer who had radical prostatectomy procedures had a 10-year cancer-specific survival rate of 92% and an overall survival rate of 77%, researchers from two institutions recently reported.

The cancer-specific survival rate for patients who had radiation therapy alone was 88%, and the overall survival rate was 52%. The findings were presented at the AUA North Central Section annual meeting in Chicago.

"It’s long been believed that patients with aggressive prostate cancer are not candidates for surgery," said Stephen Boorjian, MD, of Mayo Clinic, Rochester, MN. "We found that surgery does provide excellent long-term cancer control for this type of prostate cancer. In addition, by allowing the targeted use of secondary therapies such as androgen deprivation, surgery offers the opportunity to avoid or at least delay the potentially adverse health consequences of these treatments."

Of the 1,847 patients with aggressive prostate cancer included in the study from 1988 to 2004, 1,238 underwent surgery at Mayo Clinic and 609 were treated with radiation therapy at Fox Chase Cancer Center, Philadelphia. Of the 609 receiving radiation therapy, 344 also received androgen deprivation therapy.

The cancer-specific survival rate was equal for those who had surgery and those treated with radiation plus hormone therapy (92%). However, the overall survival rate was significantly better among those who had the surgery (77%) than those who had radiation plus hormones (67%) or those who had radiation alone (52%).

"Patients with radiation and hormone therapy were 50% more likely to die than patients who had surgery," Dr. Boorjian said. "This was true even after controlling for patient age, comorbidities, and features of the tumors. These results suggest that use of hormone therapy in patients who received radiation therapy may have had adverse health consequences."