Patients battling the most aggressive form of prostate cancer are good candidates for prostate surgery, and it could extend their lives, new research indicates.
A team of researchers from the Mayo Clinic in Rochester, Minn., and the Fox Chase Cancer Center in Philadelphia reported that 92 percent of patients with “high-risk prostate cancer” who underwent a radical prostatectomy procedure had a 10-year cancer-specific survival rate of 92 percent, equal to the survival rate after a combination of radiation and androgen (hormone) deprivation therapy.
But the overall survival rate after a radical prostatectomy, which involves removal of the prostate, was higher (77 percent) than either radiation and androgen therapy (67 percent), or radiation alone (52 percent), the investigators found.
The study findings were to be presented Monday at the American Urological Association meeting in Chicago.
“It’s long been believed that patients with aggressive prostate cancer are not candidates for surgery,” study author Dr. Stephen Boorjian, a Mayo Clinic urologist, said in a Mayo news release. “We found that surgery does provide excellent long-term cancer control for this type of prostate cancer.”
In addition, he said, “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.”
Boorjian and his colleagues focused on nearly 1,850 patients diagnosed with aggressive prostate cancer between 1988 and 2004.
Almost 1,240 of these patients underwent surgical treatment, while more than 600 underwent radiation therapy. Among the latter, 344 also were treated with androgen deprivation therapy.
“Patients with radiation and hormone therapy were 50 percent more likely to die than patients who had surgery,” Boorjian noted. “This was true even after controlling for patient age, co-morbidities 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.”
But, he added, “further studies evaluating the differing impacts of treatments on quality of life and non-cancer mortality are necessary before we can determine the best approach for patients with aggressive prostate cancer.”