Win ratio analysis of short-term clinical outcomes of focal therapy and robot-assisted radical prostatectomy for the patients with localized prostate cancer

• Published in: Scientific reports Vol. 14; no. 1; pp. 17019 - 9
• Main Authors: Teramoto, Asuka, Sakamaki, Kentaro, Shoji, Sunao, Uemura, Kohei
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 24-07-2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4025; 692/4025/1752; Aged; Clinical outcome; Clinical outcomes; Focal therapy; Follow-Up Studies; Humanities and Social Sciences; Humans; Male; Middle Aged; multidisciplinary; Propensity Score; Prostate cancer; Prostatectomy; Prostatectomy - methods; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Robot-assisted radical prostatectomy; Robotic surgery; Robotic Surgical Procedures - methods; Science; Science (multidisciplinary); Treatment Outcome; Win ratio; Clinical outcome; Robot-assisted radical prostatectomy; Prostate cancer; Focal therapy; Win ratio
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-67592-8

We compared the comprehensive clinical outcomes of focal therapy (FT) and robot-assisted radical prostatectomy (RARP) in patients with localized prostate cancer (PC) using a win ratio analysis. After propensity score matching, a win ratio analysis, in which the composite endpoints of failure-free survival (FFS) and the urinary domain of the Expanded Prostate Cancer Index Composite (EPIC) were analyzed, was used for the comparison of the clinical outcomes of FT and RARP for the patients with localized PC. Seventy-two patients were included in each group after propensity score matching. FFS was not significantly different between the groups (
p
 = 0.5044) after 36 months of follow-up. In contrast, the score of the urinary domain of the EPIC in the FT group was significantly better than that in the RARP group (
p
 < 0.0001). The win ratio of FT per RARP was 3.39 (
p
 < 0.0001; 95% confidence interval 2.21–5.20), suggesting a higher comprehensive outcome in the FT group than in the RARP group during short-term follow-up in single institution. Although further randomized trial with long-term follow-up would be needed for the evaluation, the win ratio would be useful to analyze the efficacy of FT according to patient preferences comprehensively.