Rami Klaff1, Johan Rosell2, Eberhard Varenhorst3, Gabriel Sandblom4. 1. Department of Urology, Linköping University, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. Electronic address: rami.klaff@gmail.com. 2. Regional Cancer Centre, Southeast, Region, Linköping, Sweden. 3. Department of Urology, Linköping University, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. 4. Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Hospital, Huddinge, Sweden.
Abstract
OBJECTIVE: To identify prognostic factors, and to estimate the long-term disease-specific and annual disease-specific mortality rates of low-risk prostate cancer patients from the early prostate-specific antigen (PSA) era. PATIENTS AND METHODS: We studied data extracted from the Southeast Region Prostate Cancer Register in Sweden, on1300 patients with clinically localized low-risk tumors, T1-2, PSA level ≤10 µg/L and Gleason scores 2-6 or World Health Organization Grade 1, diagnosed 1992-2003. The Cox multivariate regression model was used to evaluate factors predicting survival. Prostate cancer death rates per 1000 person-years were estimated for 4 consecutive follow-up time periods: 0-5, 5-10, 10-15, and 15+ years after diagnosis. RESULTS: During the follow-up of overall survivors (mean 10.6 years; maximum 21.8 years), 93 patients (7%) died of prostate cancer. Cancer-specific survival was 0.98 (95% confidence interval [CI] 0.97-0.99), 0.95 (95% CI 0.93-0.96), 0.89 (95% CI 0.86-0.91), and 0.84 (95% CI 0.80-0.88), 5, 10, 15, and 20 years after diagnosis. The 5-year increases in cancer-specific mortality were statistically significant (P < .001). Patients with PSA ≥ 4 µg/L managed initially with watchful waiting and those aged 70 years or older had a significantly higher risk of dying from their prostate cancer. CONCLUSION: The long-term disease-specific mortality of low-risk localized prostate cancer is low, but the annual mortality rate from prostate cancer gradually increases. This indicates that some tumors slowly develop into lethal cancer, particularly in patients 70 years or older with a PSA level ≥ 4 µg/L.
OBJECTIVE: To identify prognostic factors, and to estimate the long-term disease-specific and annual disease-specific mortality rates of low-risk prostate cancerpatients from the early prostate-specific antigen (PSA) era. PATIENTS AND METHODS: We studied data extracted from the Southeast Region Prostate Cancer Register in Sweden, on1300 patients with clinically localized low-risk tumors, T1-2, PSA level ≤10 µg/L and Gleason scores 2-6 or World Health Organization Grade 1, diagnosed 1992-2003. The Cox multivariate regression model was used to evaluate factors predicting survival. Prostate cancer death rates per 1000 person-years were estimated for 4 consecutive follow-up time periods: 0-5, 5-10, 10-15, and 15+ years after diagnosis. RESULTS: During the follow-up of overall survivors (mean 10.6 years; maximum 21.8 years), 93 patients (7%) died of prostate cancer. Cancer-specific survival was 0.98 (95% confidence interval [CI] 0.97-0.99), 0.95 (95% CI 0.93-0.96), 0.89 (95% CI 0.86-0.91), and 0.84 (95% CI 0.80-0.88), 5, 10, 15, and 20 years after diagnosis. The 5-year increases in cancer-specific mortality were statistically significant (P < .001). Patients with PSA ≥ 4 µg/L managed initially with watchful waiting and those aged 70 years or older had a significantly higher risk of dying from their prostate cancer. CONCLUSION: The long-term disease-specific mortality of low-risk localized prostate cancer is low, but the annual mortality rate from prostate cancer gradually increases. This indicates that some tumors slowly develop into lethal cancer, particularly in patients 70 years or older with a PSA level ≥ 4 µg/L.
Authors: Jason M Slater; Jerry D Slater; Joseph I Kang; Ivan C Namihas; B Rodney Jabola; Kelcie Brown; Roger Grove; Cherie Watt; David A Bush Journal: Int J Part Ther Date: 2019-08-06
Authors: Suzanne K Chambers; Shu Kay Ng; Peter Baade; Joanne F Aitken; Melissa K Hyde; Gary Wittert; Mark Frydenberg; Jeff Dunn Journal: Psychooncology Date: 2017-01-11 Impact factor: 3.894