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MP53-05 SURVIVAL OUTCOME DIFFERENCES BETWEEN CRYOSURGERY AND RADIATION FOR PROSTATE CANCER

INTRODUCTION AND OBJECTIVE: Modern treatment options for prostate cancer, such as Cryotherapy (Cryo) and Radiation (Rx), continue to evolve and grow in popularity; however, comparative outcomes data for these modalities remain sparse and are primarily reported from single-institutional studies. Physicians and patients must consider survival outcomes of treatment modalities when choosing a definitive treatment for prostate cancer. This analysis utilized the National Cancer Database to evaluate differences in survival outcomes for prostate cancer patients undergoing Cryo compared to Rx therapy. METHODS: Groups were compared using the two-sample t-test for continuous variables, and the chi-square test/Monte Carlo Estimate for the Fisher's exact test, for categorical. Propensity score matching (PSM) using SAS macro OneToManyMTCH achieved comparability of groups with regard to the following potential confounding variables: age, sex, race, Spanish/Hispanic origin, year of diagnosis, behavior, grade, and Clinical and Pathologic TNM stages. McNemar's test was used to assess 30, 90-day mortalities, vital status, and readmission. Overall survival was assessed using the stratified log-rank test. Results were significant at p<0.05. All analyses used SAS version 9.4. RESULTS: A Propensity Score Matched Pairs Analysis using McNemar's Test of 10,190 matched pairs (n[20,380 subjects) revealed patients treated with Cryo experienced higher rates of 30 and 90 day mortality (p[0.0003 and p[0.0002, respectively), as well as greater readmission rates within 30 days of discharge (p[<0.0001) compared to Rx patients. Patients treated with Rx similarly demonstrated improved overall survival compared to Cryo patients. CONCLUSIONS: Compared with Cryo, Rx results in lower perioperative and overall mortality, as well as decreased readmission rates. This may reflect differences in perioperative complications, patient choice, or other unknown variables between the two treatment modalities, although prospective studies are needed to determine the short and long term efficacies of these therapies.