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Prostate Cancer: Localized: Surgical Therapy II (PD19): Podium 19: Saturday, September 11, 2021

PD19-05 A COMPARISON OF THE SURVIVAL OUTCOMES OF ROBOTIC-ASSISTED RADICAL PROSTATECTOMY AND RADIATION THERAPY FOR LOCALIZED/LOCALLY ADVANCED PROSTATE CANCER IN MEN OVER 75 YEARS OLD; A KOREAN MULTICENTER STUDY

Ko, Young-Hwii; Joung, Jae Young; Byun, Seok-Soo; Ha, U-Syn; Park, Sung-woo; Jeon, Seong Soo; Kwak, Cheol

doi: 10.1097/JU.0000000000002008.05
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INTRODUCTION AND OBJECTIVE:

To determine and compare overall survivals (OSs) and cancer-specific survivals (CSSs) after robotic-assisted radical prostatectomy (RARP) and radiation therapy (RT), the latter of which has long been recommended primarily for elderly patients (≥75 years) with non-metastatic prostate cancer (PCa), given the contemporary Korean life span of 79.7 years (2018).

METHODS:

Retrospective data for aged ≥ 75 years who underwent RARP or RT at seven tertiary hospitals were analyzed. To account for indication-related bias, inverse probability of treatment-weighting (IPTW) was applied before unadjusted and adjusted Cox proportional hazards regression modeling.

RESULTS:

Of the 1,110 study subjects, 883 underwent RARP and 227 RT. Though there were differences in the age distribution (≥80 yrs; 25.4% vs 32.8%, p=.034), concomitant diabetes (14.9% vs 22.9%, p=.007) and coronary heart disease (3.5% vs. 7.5%, p=.015), and particularly in PCa risk stratification (high risk; 18.2 vs. 59.7%, p<.001) between groups, all of these were balanced after IPTW. During a mean follow-up of 74.5 months, OSs (91.9% vs. 91.0%) and CSSs (97.8% vs. 98.0%) were similar. After IPTW, OS was negatively associated with diabetes (HR=2.27, p<.001) and risk stratification (low-risk; HR=.0314, p<.001), the last of which was solely associated with CSS (HR=.245, p=.0005). The implementation of local treatment between RARP and RT demonstrated no impact on survival both in whole subjects and in the high-risk subpopulation.

CONCLUSIONS:

Even the patient over 75 years old who could afford to undergo RARP for non-metastatic PCa had a similar survival in comparison with RT, regardless of risk stratification.

Source of Funding:

None

© 2021 by American Urological Association Education and Research, Inc.