{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:41:43Z","timestamp":1787164903414,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T00:00:00Z","timestamp":1742601600000},"content-version":"vor","delay-in-days":80,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Advances in Urology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background and Objective:<\/jats:bold>\n                    The optimal definitive treatment for localized prostate cancer (PCa)\u2014radical prostatectomy (RP) or intensity\u2010modulated radiation therapy with image guidance (IMRTG) remains controversial. This study compares the long\u2010term clinical outcomes of RP and IMRTG in patients with PCa.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    We retrospectively analyzed 884 consecutive PCa patients over 25\u2009years. Among them, 610 (69%) underwent RP, while 274 (31%) received IMRTG starting in 2011. The primary objective was to comprehensively assess both treatment modalities.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    The median age was 68\u2009years in the RP cohort and 73\u2009years in the IMRTG cohort. The median operation time for RP was 4.11\u2009h, with nerve\u2010sparing procedures performed in 45% of cases. Median blood loss was 310\u2009mL, the urinary incontinence rate was 13%, and the median hospital stay was 14\u2009days. In the RP cohort, 46 complications (28%) occurred, including a Grade 4 rectal injury and a Grade 4 wound insufficiency. In the IMRTG cohort, over 80% of patients experienced radiation\u2010induced urological complications, with 11% reporting Grade 2 adverse effects. During a median follow\u2010up of 98\u2009months, there were 79 all\u2010cause deaths and 7 PCa\u2010specific deaths. The 15\u2010year overall survival (OS) rates were 80.9% for RP and 58.3% for IMRTG; however, this difference was not significant in the multivariate analysis, likely due to a higher proportion of high\u2010risk disease in the IMRTG cohort. Approximately 45% of all deaths were attributed to malignant tumors.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    This long\u2010term retrospective study provides valuable insights into the comparative effects of RP and IMRTG on OS in PCa patients. Both treatments are associated with distinct adverse events, complications, and impacts on urinary continence and sexual function, highlighting the importance of individualized clinical decision\u2010making.\n                  <\/jats:p>","DOI":"10.1155\/aiu\/6412793","type":"journal-article","created":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T11:26:32Z","timestamp":1742729192000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Long\u2010Term Clinical Outcomes of Radical Prostatectomy Versus Image\u2010Guided and Intensity\u2010Modulated Radiation Therapy for Prostate Cancer: A Retrospective and Comparative 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