Outcomes Measured In Relation To Radical Prostectomy, External Beam Radiation, And Seen Implant Therapy

Philadelphia, PA--Implanting radioactive-filled seeds into a cancerous prostate gland has been a largely sucessful method of treating the second-leading cancer killer among men for more than two decades. However, a new study says that, after an estimated 41-month follow-up, patients classified as high-risk had a poorer outcome after being treated with the seed implant therapy compared to those who underwent either radical prostectomy or external beam radiation. These findings are published in the September 16, 1998 issue of the Journal of the American Medical Association (JAMA). The study also concluded that no significant difference in outcome was noted in low risk patients across all treatment modalities for this short and limited follow-up period.

"These results suggest that a particular population of patients -- those we can pre-therapeutically determine to be "high risk" -- don't do as well with the seed therapy as judged by prostate specific antigen (PSA) levels, as with alternative forms of therapy," says Alan Wein, MD, senior investigator on the study and chief of urology at the University of Pennsylvania Cancer Center.

Penn researchers used collected data from 1,872 men who were treated for their localized prostate cancer between 1989 and 1997. The men underwent one of three treatment options: radical prostectomy, external beam radiation, or seed implant therapy offered at two clinical sites.

The researchers set out to measure the rate of disease-free survival for these patients. In doing so, they used three tests: PSA, biopsy Gleason score, and the American Joint Commission on Cancer staging (AJCC) T-stage.

As background, PSA blood tests measure the level of prstate-specific antigens in the blood: the results are reported as nanograms per milli
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Contact: Sue Montgomery
smontgom@mail.med.upenn.edu
(215) 349-5657
University of Pennsylvania School of Medicine
16-Sep-1998