hospitals.jefferson.edu/new...
In this study, researchers found surgery plus radiation vs radiation pus ADT to have survival advantage. They mention an advantage of real world results vs "clinical" study results.
Interesting.....
" Another interesting finding from the research was that slightly more than half of men diagnosed with the disease did not receive combination therapies for their prostate cancer. “Two modes of treatment are recommended by both United States and European guidelines for cancer treatment. It was surprising to see only 29 percent of patients received the recommended combination therapies, and as many as 20 percent are not getting any treatment six months after their diagnosis,” said Dr. Lu-Yao. “Our data can’t tell us the reason for this deviation from guidelines and further studies are needed.”
They found that 10 years after treatment, 89 percent of the prostate removal plus radiation group was still alive. That compared with the 74 percent survival at ten years in the group that received only radiation plus hormone therapy, amounting to a 15 percent survival advantage in the group that was treated with prostate removal.
“For high-risk prostate patients we started the use of aggressive radiation therapy after surgery 20 years ago,” said Adam Dicker, Senior Vice President and Chair of the Department of Enterprise Radiation Oncology at Jefferson Health, who was not involved in the study. “We recognized that it may have curative potential.”
“However, the proportion of men undergoing prostatectomy plus radiation therapy decreased significantly over time and there were trade-offs for the survival advantages,” said Dr. Lu-Yao. Men who received the combination of surgery and radiotherapy had higher rates of erectile dysfunction (28 percent vs 20 percent) and higher rates of urinary incontinence (49 percent vs 19 percent).