PMID- 37931280
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240221
IS  - 1911-6470 (Print)
IS  - 1920-1214 (Electronic)
IS  - 1911-6470 (Linking)
VI  - 18
IP  - 2
DP  - 2024 Feb
TI  - Comparison of salvage radical prostatectomy vs. salvage ablation therapy for 
      biopsy-proven radio-recurrent localized prostate cancer.
PG  - 41-46
LID - 10.5489/cuaj.8373 [doi]
AB  - INTRODUCTION: Radiation therapy for prostate cancer is associated with a 15-20% 
      five-year recurrence rate. Patients with recurrence in the prostate only are 
      candidates for salvage local therapies; however, there is no consensus on 
      modality. This study uses registries at Memorial Sloan Kettering Cancer Center 
      (MSKCC) and University of Western Ontario (UWO) to compare the oncologic outcomes 
      of salvage radical prostatectomy (SRP) and salvage ablation (SA). METHODS: A 
      total of 444 patients were available for analysis. Due to intergroup differences, 
      propensity score methodology was used and identified 378 patients with more 
      comparable pre-salvage prostate-specific antigen (PSA), Gleason score, and 
      primary radiation treatment. Patients underwent SRP at MSKCC and SA at UWO. 
      RESULTS: Of the 378 patients, 48 died of disease, with a 6.0-year median 
      (interquartile range [IQR] 3.0, 9.7) followup among survivors; 88 developed 
      metastases, with a median 4.6-year (IQR 2.3, 7.9) followup among metastasis-free 
      survivors. There was a non-significantly higher rate of cancer-specific (hazard 
      ratio [HR ] 1.02, 95% confidence interval [CI] 0.51, 2.06, p=0.9) and improved 
      metastasis-free survival (HR 0.71, 95% CI 0.44, 1.13, p=0.15) among patients 
      undergoing SA compared to patients undergoing SRP. There were 143 patients who 
      received hormonal therapy, with higher rates of androgen deprivation therapy 
      (ADT) in SA (HR 1.42, 95% CI 0.97, 2.08, p=0.068), although this did not meet 
      conventional levels of significance. CONCLUSIONS: This propensity score analysis 
      of salvage therapy for radio-recurrent prostate cancer identified no 
      statistically significant differences in oncologic outcome between SRP and SA; 
      however, there was evidence of a lower risk of ADT in the cohort undergoing SRP. 
      Given they are both potentially curative therapies, these treatments are viable 
      options for men with clinically localized, radio-recurrent prostate cancer rather 
      than ADT alone. Future research may further elucidate subpopulations that may be 
      more amenable to either SRP or SA.
FAU - McPherson, Victor
AU  - McPherson V
AD  - Division of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, United 
      States.
AD  - Division of Urology, McGill University, Montreal, QC, Canada.
FAU - Nair, Shiva M
AU  - Nair SM
AD  - Division of Urology, Western University, London Health Sciences Center, London, 
      ON, Canada.
FAU - Tin, Amy L
AU  - Tin AL
AD  - Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer 
      Center, New York, NY, United States.
FAU - Dewar, Malcolm
AU  - Dewar M
AD  - Division of Urology, Western University, London Health Sciences Center, London, 
      ON, Canada.
FAU - Siddiqui, Khurram
AU  - Siddiqui K
AD  - Division of Urology, Western University, London Health Sciences Center, London, 
      ON, Canada.
FAU - Sjoberg, Daniel D
AU  - Sjoberg DD
AD  - Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer 
      Center, New York, NY, United States.
FAU - Vickers, Andrew J
AU  - Vickers AJ
AD  - Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer 
      Center, New York, NY, United States.
FAU - Eastham, James
AU  - Eastham J
AD  - Division of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, United 
      States.
FAU - Chin, Joseph L
AU  - Chin JL
AD  - Division of Urology, Western University, London Health Sciences Center, London, 
      ON, Canada.
LA  - eng
GR  - P30 CA008748/CA/NCI NIH HHS/United States
PT  - Journal Article
PL  - Canada
TA  - Can Urol Assoc J
JT  - Canadian Urological Association journal = Journal de l'Association des urologues 
      du Canada
JID - 101312644
PMC - PMC10841561
COIS- COMPETING INTERESTS: Dr. McPherson has been an advisory board member for Knight 
      and TerSera; and has received grants/honoraria from Abbvie, Bayer, Knight, and 
      TerSera. Dr. Chin has been an advisory board member for Abbvie, Johnson & 
      Johnson, TerSera, and Theralase; a consultant for Profound; and has participated 
      in clinical trials supported by Astellas, Janssen, Pfizer, and Profound. All 
      other authors do not report any competing personal or financial interests related 
      to this work.
EDAT- 2023/11/06 18:41
MHDA- 2023/11/06 18:42
PMCR- 2024/02/01
CRDT- 2023/11/06 17:13
PHST- 2023/11/06 18:42 [medline]
PHST- 2023/11/06 18:41 [pubmed]
PHST- 2023/11/06 17:13 [entrez]
PHST- 2024/02/01 00:00 [pmc-release]
AID - cuaj.8373 [pii]
AID - cuaj-2-41 [pii]
AID - 10.5489/cuaj.8373 [doi]
PST - ppublish
SO  - Can Urol Assoc J. 2024 Feb;18(2):41-46. doi: 10.5489/cuaj.8373.