Little variation in outcomes among PCa treatments

A comprehensive retrospective study found little variation in outcome for low-risk prostate cancer patients among the major treatment types, although significant cost differences were observed.

For the study, which was published online in the British Journal of Urology International (Dec. 28, 2012), researchers from the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center analyzed 232 papers published in the last decade that reported results from clinical studies following patients with low-, intermediate- and high-risk prostate cancer who were treated with radiation therapy, radical prostatectomy, hormone therapies, and/or brachytherapy.

The analysis showed that for people with low-risk prostate cancer, the various forms of treatment vary only slightly in terms of survival, with a 5-year cancer-specific survival rate of nearly 100%. But radiation therapy is significantly more expensive than surgery for low-risk prostate cancer, the authors found.

For intermediate- and high-risk cancers, both survival and cost generally favored surgery over other forms of treatment—although combination external-beam radiation and brachytherapy together were comparable in terms of quality of life-adjusted survival for high-risk prostate cancer.

"Our findings support a greater role for surgery for high-risk disease than we have generally seen it used in most practice settings," said first author Matthew Cooperberg, MD, MPH.

The study did not consider active surveillance or proton therapy, the latter of which is much more expensive and has already been shown in multiple studies not to be cost-effective, said Dr. Cooperberg.