Radiology, Vol 184, 333-339, Copyright © 1992 by Radiological Society of North America
Results of radical perineal prostatectomy with adjuvant brachytherapy
JF Doornbos, DH Hussey, RA Robinson, BC Wen and AP Vigliotti
Department of Radiology, University of Iowa College of Medicine, Iowa City 52242-1009.
Retrospective analysis of outcome in 137 patients who underwent radical
perineal prostatectomy and bilateral injection of gold-198 implants into
the periprostatic tissues and/or neurovascular pedicles as treatment for
prostatic adenocarcinoma was performed. Patients had undergone treatment
between 1975 and 1985. Local recurrence developed in 22 patients (16.1%)
and distant metastases developed in 33 (24.1%). Clinical and surgical
staging of disease and Gleason grading of pathologic specimens were
performed retrospectively. Kaplan-Meier local recurrence, freedom from
relapse (FFR), and survival rates decreased with increasing stage and
pathologic grade. With clinical staging, these rates were not statistically
different from previous rates achieved with external beam radiation
therapy, and with pathologic staging, they were not statistically different
from previous rates achieved with prostatectomy. The authors conclude that
(a) 5-year follow-up is inadequate to determine local control rates after
prostatectomy; (b) use of implants did not improve local control, FFR, or
survival rates of 10 years; and (c) method of staging probably has more
effect on local control, FFR, and survival rates than does treatment
modality.
