Cn. Coleman et al., RATE OF RELAPSE FOLLOWING TREATMENT FOR LOCALIZED PROSTATE-CANCER - ACRITICAL ANALYSIS OF RETROSPECTIVE REPORTS, International journal of radiation oncology, biology, physics, 28(1), 1994, pp. 303-313
Citations number
100
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Purpose: Controversy exists over the optimal treatment for patients wi
th clinically localized prostate cancer. Almost all of the treatment r
esults are from non-randomized trials and interseries comparison is di
fficult since the apparent success of a treatment, as judged by the ac
tuarial freedom from relapse and survival data, depends on patient sel
ection criteria and post-treatment evaluation, in addition to the effi
cacy of the therapeutic intervention. In this report the calculation o
f a hazard function is used to estimate and compare the rate of relaps
e for the different treatments. Methods and Materials: Clinical report
s from major surgery and radiation oncology treatment institutions wer
e analyzed. The actuarial recurrence data were used to calculate the a
nnual rate of recurrence within each series. Results: For all but the
lowest volume tumors, patients continue to be at risk of relapse for a
s long as these series have been followed. Despite the heterogeneity o
f patient populations, the recurrence rates by stage are similar for p
atients treated with surgery or irradiation. This result is consistent
with pathologic data from prostatectomy specimens which indicate that
for lesions > 12 cm(3) (approx. 3 cm in diameter) there is high likel
ihood of extra-prostatic disease. Conclusion: Treatment outcome for pa
tients with localized prostate cancer may be more dependent on the inh
erent tumor biology than the particular type of treatment. Accordingly
, the expectation and recommendation of a treatment must take into con
sideration the continued risk of relapse with either radiation therapy
or surgery. There are, as yet, insufficient data regarding the impact
of screening and earlier diagnosis on the curability of patients with
localized prostate cancer.