The researchers’ analysis included 19 studies that pooled data on up to 118,830 patients. For overall cause of death, the adjusted hazard ratio for patients treated with radiation versus surgery was 1.63. For prostate cancer-specific death, the adjusted hazard ratio for patients treated with radiation versus surgery was 2.0. Subgroup analysis by risk group, radiation regimen, time period and follow-up length “did not alter the direction of results,” the authors wrote.
Most of the studies included patients treated with external beam radiation, although some included patients treated with brachytherapy separately or with external beam radiation.
The studies included in the analysis were observational and thus have a potential for bias. Still, the authors noted that these data, “combined with forthcoming randomized data, may aid clinical decision making.”
The study was reported online ahead of print in European Urology.