The treatment of choice for localized poorly differentiated adenocarcinoma of the prostate.

Of 286 evaluable patients definitively irradiated for adenocarcinoma of the prostate, 71 with Stage B2 and C poorly differentiated lesions were studied. Forty-six patients were treated with external beam therapy and 25 with 125I implantation and pelvic lymph node dissection. Within both the external beam and the 125I treatment groups, the local recurrence rate was noticeably higher in the Stage C than in the Stage B2 tumors. Moreover, the incidence of local failure was significantly increased in those patients treated with 125I implantation, 56% vs. 24% (p = 0.008), suggesting that external beam irradiation may be the treatment of choice for localized, poorly differentiated prostatic tumors.