BACKGROUND: The efficacy of prostate cancer (PCa) treatment modalities is a subject of continuous debate. OBJECTIVE: We tested the hypothesis that significant differences in survival rates may exist among PCa patients treated with radical prostatectomy (RP), radiation therapy (RT), and observation. DESIGN, SETTING, AND PARTICIPANTS: We focused on 404,604 patients with clinically localized PCa within 17 Surveillance, Epidemiology and End Results registries. MEASUREMENTS: Competing-risks survival analyses were used to estimate cancer-specific mortality (CSM) and other-cause mortality (OCM) rates. Patients were stratified according to treatment type, age group, and PCa risk group (high risk: T2c and/or Gleason score 8-10; low to intermediate risk: all others). RESULTS AND LIMITATIONS: The 10-yr CSM and OCM rates were 6.1% and 29.2%, respectively. In RP, RT, and observation patients, CSM rates were 3.6%, 6.5%, and 10.8% (p<0.001), respectively; OCM rates were 17.1%, 32.4%, and 48.9% (p<0.001), respectively. In low- to intermediate-risk patients, the lowest CSM (1.3-3.7%) and OCM (6.9-31.6%) rates within all age categories except octogenarians (8.9% and 62.8%, respectively) were recorded in RP. In high-risk patients, the lowest CSM (5.8-7.2%) and OCM (8.7-16.1%) rates in patients aged ≤69 yr were also recorded in RP. RT was equally favorable to RP in the 70-79 age category and appeared ideal in all octogenarian patients. CONCLUSIONS: Our results showed that RP provides the most favorable survival rates in most patients. The exception is octogenarian men, in whom RT provides the best results. Finally, the least-favorable outcomes were recorded after observation. However, these findings must be interpreted within the context of the limitations of observational data.
BACKGROUND: The efficacy of prostate cancer (PCa) treatment modalities is a subject of continuous debate. OBJECTIVE: We tested the hypothesis that significant differences in survival rates may exist among PCa patients treated with radical prostatectomy (RP), radiation therapy (RT), and observation. DESIGN, SETTING, AND PARTICIPANTS: We focused on 404,604 patients with clinically localized PCa within 17 Surveillance, Epidemiology and End Results registries. MEASUREMENTS: Competing-risks survival analyses were used to estimate cancer-specific mortality (CSM) and other-cause mortality (OCM) rates. Patients were stratified according to treatment type, age group, and PCa risk group (high risk: T2c and/or Gleason score 8-10; low to intermediate risk: all others). RESULTS AND LIMITATIONS: The 10-yr CSM and OCM rates were 6.1% and 29.2%, respectively. In RP, RT, and observation patients, CSM rates were 3.6%, 6.5%, and 10.8% (p<0.001), respectively; OCM rates were 17.1%, 32.4%, and 48.9% (p<0.001), respectively. In low- to intermediate-risk patients, the lowest CSM (1.3-3.7%) and OCM (6.9-31.6%) rates within all age categories except octogenarians (8.9% and 62.8%, respectively) were recorded in RP. In high-risk patients, the lowest CSM (5.8-7.2%) and OCM (8.7-16.1%) rates in patients aged ≤69 yr were also recorded in RP. RT was equally favorable to RP in the 70-79 age category and appeared ideal in all octogenarian patients. CONCLUSIONS: Our results showed that RP provides the most favorable survival rates in most patients. The exception is octogenarian men, in whom RT provides the best results. Finally, the least-favorable outcomes were recorded after observation. However, these findings must be interpreted within the context of the limitations of observational data.
Authors: Charles B Simone; Molykutty John-Aryankalayil; Sanjeewani T Palayoor; Adeola Y Makinde; David Cerna; Michael T Falduto; Scott R Magnuson; C Norman Coleman Journal: Transl Oncol Date: 2013-10-01 Impact factor: 4.243
Authors: Phillip M Pierorazio; Ashley E Ross; Brian M Lin; Jonathan I Epstein; Misop Han; Patrick C Walsh; Alan W Partin; Christian P Pavlovich; Edward M Schaeffer Journal: BJU Int Date: 2012-02-28 Impact factor: 5.588
Authors: Pirus Ghadjar; Alberto Briganti; Peter J L De Visschere; Jurgen J Fütterer; Gianluca Giannarini; Hendrik Isbarn; Piet Ost; Prasanna Sooriakumaran; Christian I Surcel; Roderick C N van den Bergh; Inge M van Oort; Ofer Yossepowitch; Guillaume Ploussard Journal: World J Urol Date: 2014-07-05 Impact factor: 4.226
Authors: Paolo Dell'oglio; Anne Sophie Valiquette; Sami-Ramzi Leyh-Bannurah; Zhe Tian; Vincent Trudeau; Alessandro Larcher; Shahrokh F Shariat; Umberto Capitanio; Alberto Briganti; Markus Graefen; Francesco Montorsi; Pierre I Karakiewicz Journal: Can Urol Assoc J Date: 2018-03-19 Impact factor: 1.862
Authors: Sophie Knipper; Cristina Dzyuba-Negrean; Carlotta Palumbo; Angela Pecoraro; Giuseppe Rosiello; Zhe Tian; Alberto Briganti; Fred Saad; Derya Tilki; Markus Graefen; Pierre I Karakiewicz Journal: Int Urol Nephrol Date: 2019-09-21 Impact factor: 2.370