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Radiation Oncology • Genitourinary Cancers
How should radiation oncologists respond to the recent meta-analysis concluding that prostate cancer-specific mortality is lower following prostatectomy vs radiation therapy?
The forrest plot in the recent meta-analysis published in European Urology is rather impressive, even in the more recent high dose radiation series. Their conclusion that overall survival is better with RP is not surprising given the typical age and comorbidities of radiotherapy patients.
Answer from: Radiation Oncologist at Academic Institution
Prior comparisons that suggested equivalence with surgery and dose escalated RT focused on biochemical control. However, with longer follow-up, comparative studies suggest superiority for surgery over EBRT for the harder endpoints of metastasis and cause specific survival. This is most evident amon...
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Answer from: Radiation Oncologist at Academic Institution
Wait for the results of Protect study...Rumored to be published in SeptemberUntil then the rebuttal found in the letter by Bari should suffice; PubMed link below.http://www.ncbi.nlm.nih.gov/pubmed/27267818
Answer from: Radiation Oncologist at Community Practice
If you are referring to the Chris Wallis study, it may be instructive to scroll to the bottom of the online version to see the comments that were shared back in January, 2016: http://www.europeanurology.com/article/S0302-2838(15)01160-4/fulltext/surgery-versus-radiotherapy-for-clinically-local...
Answer from: Radiation Oncologist at Community Practice
Meta Analysis is the "Intellectual Industrial Waste" of medical literature. If one has to resort to this creative methodology to attempt to flush out a difference in the first place, one already has the answer. No provable difference. . .
Answer from: Radiation Oncologist at Academic Institution
Here is an article to reference "Radiation therapy versus radical prostatectomy: A never-ending discussion."These studies comparing surgery to radiation have many common features. First, they assume a cause and effect relationship between the survival difference and the treatment. Second, they claim...
Answer from: Radiation Oncologist at Community Practice
I wonder how many surgeons would discuss the results of the LAPPRO trial or the CaPSURE database with patients before surgery. Also, I wonder how many surgeons know the results of using HDR and 5 fraction SABR for all risk groups.BJU Int. 2016 Aug;118(2):205-12. doi: 10.1111/bju.13444. Epub 2016 Mar...