Surgery is more effective than radiation therapy at treating localized prostate cancer and more likely to prolong the life of patients undergoing the procedure, according to results of a new study by Canadian researchers. The study, titled “Surgery Versus Radiotherapy for Clinically-localized Prostate Cancer: A Systematic Review and Meta-analysis,” was published in the journal European Urology.
More than 90% of prostate cancer patients are diagnosed with localized cancer restricted to the prostate tissue. In such cases, the treatment is usually either surgery or radiotherapy, therapeutic choices that can vary among patients and clinicians. The main mode of detection is serum prostate-specific antigen testing.
In the present study, carried out at the Odette Cancer Centre, Sunnybrook Research Institute (University of Toronto), researchers performed a meta-analysis of 19 studies with low-to-moderate bias risk, involving up to 118,830 patients, to evaluate overall and prostate cancer-specific mortality among patients treated either with radiation (mostly external beam radiotherapy) or radical prostatectomy. This surgical procedure consists of the complete removal of the prostate. Robotic prostatectomy also, according to a press release on the study by prostate cancer surgeon Dr. David Samadi, allows for better staging and grading of the prostate tumor and is associated with a better quality of life post-treatment.
The studies came primarily from a search of Medline, EMBASE (a biomedical literature database), and the Cochrane Library through June 2015.
From the analyses, researchers found that, when looking at cancer-specific mortality, patients who were treated with radiotherapy were twice as likely to die as patients who underwent surgery. Analyses of studies evaluating overall mortality further indicated that patients treated with radiotherapy were about 1.5 times more likely to die earlier than those treated with surgery.
The results, the researchers say, show that surgery for the treatment of localized prostate cancer is more effective and offers a better long-term prognosis than radiation therapy.
“In the past, studies that have compared the success rates of surgery or radiation have been confusing because of their methods. We have evaluated all the good-quality data comparing surgery and radiotherapy, and the results are pretty conclusive; in general, surgery results in better mortality rates than radiotherapy,” said the study’s senior author, Dr. Robert Nam.