Men with very high-risk prostate cancer, who are diagnosed and treated in hospitals where radical local treatments such as full-dose radiotherapy and prostatectomy are widely used, are twice more likely to survive than those who are treated in hospitals where such treatments are rarely used.
In the study “Association of Radical Local Treatment with Mortality in Men with Very High-risk Prostate Cancer: A Semiecologic, Nationwide, Population-based Study,” published in European Urology, Dr. Pär Stattin, a professor at the Department of Surgical and Perioperative Sciences at Umeå University in Sweden, and colleagues, investigated the impact of full-dose radiotherapy and prostatectomy on themortality rates of patients with deadly high-risk prostate cancer.
Using the National Prostate Cancer Register (NPCR) of Sweden, researchers analyzed data from patients under age 80 who had been diagnosed with prostate cancer between 1998 and 2012, and received full-dose radiotherapy or prostatectomy in 640 experimental hospital units.
They saw that the mortality rate was lower by half in units with the highest availability of radical local treatment compared to those with the lowest availability of radical treatment.
But the study was not able to distinguish for certain, if the effect was due to more effective treatment or better diagnosis.
“Our data suggests that there are benefits of radical local therapy for men with very advanced forms of prostate cancer. However, these men most often only receive hormonal treatment. To confirm our findings and hopefully to improve treatment praxis, there is a need for a randomized study of the effects of local radical therapy on patients with very high-risk prostate cancer,” Stattin said in a press release.
Very high-risk prostate cancer is the “grey zone” between locally advanced and metastatic prostate cancer. It is defined when the cancer invades adjacent organs, or when the level of prostate-specific antigens in the blood of patients is very high but there is no metastasis.
Radical local treatments, such as radiotherapy and surgery, is infrequently considered beneficial for very high-risk patients because the local tumor is often too advanced to remove completely and a high likelihood of undetected micro metastases exists.
The recent study concluded that radical treatment decreases mortality even in men with very high-risk prostate cancer for whom such treatment may have been predicted as ineffective.