Long-term outcomes and prognostic factors in patients treated with intraoperatively planned prostate brachytherapy

PURPOSE: Evaluate outcomes and prognostic factors in men with localized prostate cancer. METHODS AND MATERIALS: A total of 3760 patients have undergone prostate seed implantation at our institution. This review is of our initial 304 consecutive patients treated before January 30, 2001. A total of 124 patients were treated with 1251 implant monotherapy and 180 with Pd-103 implant combined with 45-Gy external beam, radiation therapy. RESULTS: The median followup. was 10.3 years, A 10-year biochemical control for low risk (LR) was 98%, intermediate risk (IR) 94%, high risk (HR) 78%, and HR with one HR factor 88% (p < 0.001); cause-specific survival was 99%,. 98%,. and 84% for LR, IR, and HR, respectively (p < 0.001);, No significant difference in outcome was seen for LR and IR patients (P > 0.3). On multivariate analysis, only pretreatment PSA, Gleason score, and T-stage were significant for biochemical control. Most biochemical failures occurred within 5 years (93%). CONCLUSIONS: With a minimum followup of 10 years, results are excellent and do not differ for LR or IR prostate cancer patients. HR patients are. a very heterogeneous group, and excellent results can still be achieved for HR. patients with only one HR feature. (C) 2013 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.