RADICAL PROSTATECTOMY AND ROBOTIC RADIOSURGERY AS TREATMENT OPTIONS FOR LOCALIZED PROSTATE CANCER

Purpose: to compare immediate, short-term and long-term treatment outcomes after radical prostatectomy and robotic radiosurgery in patients with localized prostate cancer.

Material and methods. The study included 2 groups of patients. Group I patients (n=80) underwent radical surgery (nerve-sparing prostatectomy). Group II patients (n=102) underwent KiberKnife stereotactic robotic radiotherapy.

Results. Immediate treatment outcomes after both radical prostatectomy and robotic radiosurgery did not demonstrate increased number of postoperative complications and severe radiation-induced injuries. The PSA level decreased and reached a nadir PSA level immediately after radical prostatectomy. After stereotactic radiation therapy, the PSA level decreased gradually every three months, reaching a nadir within a year. In the group of patients receiving CyberKnife treatment, changes in the prostate volume affected the quality of urination, which was confirmed by the assessment of the volume of residual urine. When comparing the quality of urination in treatment groups using the IPSS scale, the values were comparable. No differences in the 1-year disease-free survival rates between groups were found. However, 60 months later, disease free survival rate was higher by 8.2 % in patients treated with radiosurgery than in patients who underwent radical prostatectomy (p<0.005). No differences in the 1-year cancer-specific survival rates between the groups were found. In patients, who underwent radiosurgery, the 5-year cancer-specific survival rate was 96.3 % (3.7 % higher than that observed in patients, who underwent radical surgery, p<0.005).

Conclusion. High 5-year survival rates in patients with localized prostate cancer indicate that both radical prostatectomy and KiberKnife stereotactic robotic radiosurgery are safe and effective treatment options.

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