Failure of Open Radioactive 125Iodine Implantation to Control Localized Prostate Cancer: A Study of 41 Patients

AbstractWe studied 41 patients with localized prostate cancer who underwent bilateral pelvic lymphadenectomy with open insertion of radioactive 125iodine. Followup was a minimum of 5 years. Of the patients 13 died: 10 of recurrent prostatic adenocarcinoma (including 4 of 5 with pathological stage D1 cancer) and 3 of unrelated causes within 2 years of implantation without clinical evidence of prostate cancer. Of the 28 remaining patients 16 have known recurrence of cancer [positive bone scan and increasing prostate specific antigen (PSA) level or positive tissue biopsy]. Six patients have strong suspicion of local recurrence with elevated PSA levels (greater than 4.0 in 5) and increasing induration on digital rectal examination. Only 6 of the 41 patients (14.6%) are without evidence of disease. Openly implanted radioactive 125iodine does not appear to control effectively adenocarcinoma of the prostate.