Abstract
PURPOSE: We evaluated the clinical outcome of high-risk prostate cancer patients receiving radical prostatectomy (RP) or radiotherapy (RT). MATERIALS AND METHODS: Patients were classified as high-risk prostate cancer and received definitive treatment between 2013 and 2023. Patients with previous pelvic RT and incomplete medical record were excluded. The primary outcomes were progression-free survival (PFS) and distant metastasis-free survival (MFS). The secondary outcomes were factors for progression and metastasis. RESULTS: Of 244 patients analyzed (89 RP and 155 RT); the estimated 10-year PFS was 49.9% in the RP and 75.5% in the RT (P = 0.013). No significant difference was seen in the distant MFS (P = 0.177) and overall survival (P = 0.052). Univariate and multivariate were analyzed; the factor for progress or metastasis was initial prostate-specific antigen. CONCLUSION: Our data demonstrated that RT offers superiority over RP in PFS, whereas distant metastasis was similar.