Characteristics of Patients in SPCG-15—A Randomized Trial Comparing Radical Prostatectomy with Primary Radiotherapy plus Androgen Deprivation Therapy in Men with Locally Advanced Prostate Cancer

European Urology Open Science

Eva Johansson¹  Henriette Lindberg²  Peter Meidahl Petersen³  Johan Stranne⁴  Antti Rannikko⁵  Camilla Thellenberg Karlsson⁶  Wolfgang Lilleby⁷  Magdalena Gongora⁸  Mats Olsson⁸  Martin Andreas Røder⁹  Olof Akre^1,10  Henrik Jakobsen^1,11  Klaus Brasso^1,12  Fredrik Jäderling^1,13  Tuomas Mirtti^1,14  Matteo Bottai^1,15  Steinbjørn Hansen^1,16  Per Henrik Vincent^1,17 

[1] Corresponding author. Department of Molecular Molecule and Surgery, Karolinska Institutet, Solna, GKS D1:05, 171 76 Stockholm, Sweden. Tel. [phone].;Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark;Department of Oncology, Odense University Hospital, Odense, Denmark;Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden;Department of Radiology, Capio S:t Görans Hospital, Stockholm, Sweden;Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Clinical Research, University of Southern Denmark, Odense, Denmark;Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden;Department of Oncology, Copenhagen University Hospital − Herlev and Gentofte, Herlev, Denmark;Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Denmark;Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden;Department of Surgical Sciences, Uppsala University, Uppsala, Sweden;Department of Urology, Center for Cancer and Organ Diseases, Copenhagen Prostate Cancer Center, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark;Department of Urology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark;Department of Urology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden;Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden;Radiumhospital, Oslo University Hospital, Oslo, Norway;

关键词: Prostatic neoplasms;    Locally advanced prostate cancer;    Radical prostatectomy;    Radiotherapy;    Androgen deprivation;    Curative treatment;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: There is no high-grade evidence for surgery as primary treatment for locally advanced prostate cancer. The SPCG-15 study is the first randomized trial comparing surgical treatment with radiotherapy. Objective: To describe the baseline characteristics of the first 600 randomized men in the SPCG-15 study. The study will compare mortality and functional outcomes. Design, setting, and participants: This study is a Scandinavian prospective, open, multicenter phase III randomized clinical trial aiming to randomize 1200 men. Intervention: Radical prostatectomy with or without consecutive radiotherapy (experimental) and radiotherapy with neoadjuvant androgen deprivation therapy (standard of care). Outcome measurements and statistical analysis: Cause-specific survival, metastasis-free survival, overall survival, and patient-reported bowel function, sexual health, and lower urinary tract symptoms were measured. Results and limitations: The distribution of characteristics was similar in the two study arms. The median age was 67 yr (range 45–75 yr). Among the operated men, 36% had pT3a stage of disease and 39% had pT3b stage. International Society of Urological Pathology grades 2, 3, 4, and 5 were prevalent in 21%, 35%, 7%, and 27%, respectively. Half of the men (51%) in the surgery arm had no positive lymph nodes. The main limitation is the pragmatic design comparing the best available practice at each study site leading to heterogeneity of treatment regimens within the study arms. Conclusions: We have proved that randomization between surgery and radiotherapy for locally advanced prostate cancer is feasible. The characteristics of the study population demonstrate a high prevalence of advanced disease, well-balanced comparison groups, and a demography mirroring the Scandinavian population of men with prostate cancer at large. Patient summary: This study, which has recruited >600 men, compares radiotherapy with surgery for prostate cancer, and an analysis at the time of randomization indicates that the study will be informative and generalizable to most men with locally advanced but not metastasized prostate cancer.

【 授权许可】

Unknown