Table 2.
Selected population-based database studies comparing survival endpoints for prostatectomy vs. radiotherapy.
| References | Database used/accrual period | Cohort described | Key results | Missing variables of study/limitations of database used |
|---|---|---|---|---|
| Hoffman et al. (49) | PCOS/SEER (1994–2010) | 1,655, including 437 high-risk (PSA > 10 or Gleason ≥ 8) treated with RP or XRT | High-risk results: RP was associated with statistically significant advantages for OM: HR 0.65 (95% CI 0.48–0.87), and PCM: HR: 0.36 (95% CI 0.20–0.64) | ADT duration RT dose RT modality/plan details Small sample size |
| Sooriakumaran et al. (50) | PcBaSe Sweden (1996–2010) | 32,846 including 7649 modified NCCN high-risk | HR for PCM favors RP over RT: HR = 1.50 (95% CI 1.19–1.88) | ADT use/duration RT dose RT modality/plan details |
| Ennis et al. (52) | NCDB (2004–2013) | Clinically localized, NCCN high-risk who received RP or XRT + ADT or XRT + BT ± ADT | No difference in OM between RP and XRT + BT, XRT/ADT associated with higher mortality than RP (HR, 1.53; 95% CI, 1.22–1.92). |
ADT use/duration RT dose RT modality/plan details PCM |
| Jang et al. (56) | SEER-Medicare (1992–2009) | T3-T4N0M0 or T3-T4N1M0, age ≥65 treated with RP/adjuvant XRT or XRT/ADT | 10-year PCM and OM favored men who underwent RP + XRT over men who underwent XRT + ADT | RT dose; RT modality/plan details; lack of specific information regarding biochemical/clinical recurrence; lack of patient-reported outcomes; data for non-Medicare beneficiaries <65 years |
| Muralidhar et al. (54) | NCDB and SEER (2004–2012 for NCDB and SEER) | cT1-T3N0M0, Gleason 9–10, PSA 0–40 ng/ml treated with XRT + BT or RP + ART | NCDB: No difference in 5-year OM between RP + ART vs. XRT + BT (HR 1.10, 95% CI 0.95–1.27) SEER: No difference in 5-year PCM (HR 1.22, 95% CI 0.88–1.71) |
Limitations as above for SEER and NCDB studies |
ADT, androgen deprivation therapy; ART, adjuvant radiation therapy; BT, brachytherapy; HR, hazard ratio; OM, overall mortality; NCCN, National Comprehensive Cancer Network; NCDB, National Cancer Database; PCM, prostate cancer-specific mortality; PSA, prostate-specific antigen; SEER, Surveillance, Epidemiology, and End Results; XRT, external beam radiation therapy.