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Comparative Effectiveness of Radiotherapy versus Focal Laser Ablation in Patients with Low and Intermediate Risk Localized Prostate Cancer.
Sci Rep. 2020 Jun 04; 10(1):9112.SR

Abstract

At present, focal laser ablation (FLA) as a new PCa local treatment has attracted attention. We aim at comparing the survival outcomes between radiotherapy (RT) and FLA to reveal whether FLA can be used as an alternative to RT for patients with low and intermediate-risk localized PCa.We conducted analyses with data from the SEER database (2004-2015). Propensity score matching and instrumental variate (IV) were used to reduce the influence of bias and unmeasured confounders maximally.In the adjusted multivariate regression, FLA had lower overall survival (OS) benefits (HR = 1.49; 95%CI: 1.18-1.87; p < 0.001). After propensity score matching, RT still had better OS (HR = 1.50; 95%CI: 1.17-1.93; p = 0.001). The outcomes of IV-adjusted analysis showed FLA was significantly inferior to RT in OS (HR = 1.49; 95%CI: 1.18-1.87). In the subgroup analyses, for those with PSA < 4 ng/mL, FLA showed markedly worse OS and cancer-specific mortality (CSM) outcomes (OS HR = 1.89; 95%CI: 1.01-3.53; p = 0.0466 and CSM HR = 4.25; 95%CI: 1.04-17.43; p = 0.044).FLA is a promising focal therapy of PCa. But our research demonstrated RT still had an obvious advantage in survival benefits over FLA. Using FLA as an alternative treatment for RT requires careful consideration by clinicians.

Authors+Show Affiliations

Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical big data, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical big data, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical big data, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical big data, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical big data, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical big data, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical big data, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical big data, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical big data, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China. wycleflue@163.com.Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical big data, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China. weiqiang163163@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32499484

Citation

Zhou, Xianghong, et al. "Comparative Effectiveness of Radiotherapy Versus Focal Laser Ablation in Patients With Low and Intermediate Risk Localized Prostate Cancer." Scientific Reports, vol. 10, no. 1, 2020, p. 9112.
Zhou X, Jin K, Qiu S, et al. Comparative Effectiveness of Radiotherapy versus Focal Laser Ablation in Patients with Low and Intermediate Risk Localized Prostate Cancer. Sci Rep. 2020;10(1):9112.
Zhou, X., Jin, K., Qiu, S., Jin, D., Liao, X., Tu, X., Zheng, X., Li, J., Yang, L., & Wei, Q. (2020). Comparative Effectiveness of Radiotherapy versus Focal Laser Ablation in Patients with Low and Intermediate Risk Localized Prostate Cancer. Scientific Reports, 10(1), 9112. https://doi.org/10.1038/s41598-020-65863-8
Zhou X, et al. Comparative Effectiveness of Radiotherapy Versus Focal Laser Ablation in Patients With Low and Intermediate Risk Localized Prostate Cancer. Sci Rep. 2020 Jun 4;10(1):9112. PubMed PMID: 32499484.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative Effectiveness of Radiotherapy versus Focal Laser Ablation in Patients with Low and Intermediate Risk Localized Prostate Cancer. AU - Zhou,Xianghong, AU - Jin,Kun, AU - Qiu,Shi, AU - Jin,Di, AU - Liao,Xinyang, AU - Tu,Xiang, AU - Zheng,Xiaonan, AU - Li,Jiakun, AU - Yang,Lu, AU - Wei,Qiang, Y1 - 2020/06/04/ PY - 2019/09/08/received PY - 2020/05/07/accepted PY - 2020/6/6/entrez PY - 2020/6/6/pubmed PY - 2020/6/6/medline SP - 9112 EP - 9112 JF - Scientific reports JO - Sci Rep VL - 10 IS - 1 N2 - At present, focal laser ablation (FLA) as a new PCa local treatment has attracted attention. We aim at comparing the survival outcomes between radiotherapy (RT) and FLA to reveal whether FLA can be used as an alternative to RT for patients with low and intermediate-risk localized PCa.We conducted analyses with data from the SEER database (2004-2015). Propensity score matching and instrumental variate (IV) were used to reduce the influence of bias and unmeasured confounders maximally.In the adjusted multivariate regression, FLA had lower overall survival (OS) benefits (HR = 1.49; 95%CI: 1.18-1.87; p < 0.001). After propensity score matching, RT still had better OS (HR = 1.50; 95%CI: 1.17-1.93; p = 0.001). The outcomes of IV-adjusted analysis showed FLA was significantly inferior to RT in OS (HR = 1.49; 95%CI: 1.18-1.87). In the subgroup analyses, for those with PSA < 4 ng/mL, FLA showed markedly worse OS and cancer-specific mortality (CSM) outcomes (OS HR = 1.89; 95%CI: 1.01-3.53; p = 0.0466 and CSM HR = 4.25; 95%CI: 1.04-17.43; p = 0.044).FLA is a promising focal therapy of PCa. But our research demonstrated RT still had an obvious advantage in survival benefits over FLA. Using FLA as an alternative treatment for RT requires careful consideration by clinicians. SN - 2045-2322 UR - https://www.unboundmedicine.com/medline/citation/32499484/Comparative_Effectiveness_of_Radiotherapy_versus_Focal_Laser_Ablation_in_Patients_with_Low_and_Intermediate_Risk_Localized_Prostate_Cancer L2 - http://dx.doi.org/10.1038/s41598-020-65863-8 DB - PRIME DP - Unbound Medicine ER -
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