Objective: To quantify the differences in 5-year overall survival (OS) between high-grade (Gleason sum 8–10) incidental prostate cancer (IPCa) patients and age-matched male population-based controls, according to treatment type: no active versus active treatment. Materials and Methods: We relied on the Surveillance, Epidemiology, and End Results (SEER) database (2004–2015) to identify not actively treated and actively treated high-grade IPCa patients. For each case, we simulated an age-matched male control (Monte Carlo simulation), relying on Social Security Administration Life Tables (2004–2020) with 5 years of follow-up. Additionally, we relied on Kaplan–Meier plots to display OS for each treatment type. Multivariable Cox regression models were fitted to predict overall mortality (OM). Results: Of 564 high-grade IPCa patients, 345 (61%) were not actively treated versus 219 (39%) were actively treated, either with radical prostatectomy or radiotherapy. Median OS was 3 years for not actively treated high-grade IPCa patients, with OS difference at 5 years follow-up of 27% relative to their age-matched male population-based controls (37% vs. 64%). Median OS was 8 years for actively treated high-grade IPCa patients, with OS difference at 5 years follow-up of 6% relative to their age-matched male population-based controls (68% vs. 74%). In the multivariable Cox regression model, active treatment independently predicted lower OM (hazard ratio = 0.6; 95% confidence interval = 0.4–0.8; p < 0.001). Conclusion: Relative to Life Tables' derived age-matched male controls, not actively treated high-grade IPCa patients exhibit drastically worse OS than their actively treated counterparts. These observations may encourage clinicians to consider active treatment in newly diagnosed high-grade IPCa patients.
Life Expectancy in High-Grade Incidental Prostate Cancer Patients Versus Population-Based Controls According to Treatment Type / F. Di Bello, L.M.I. Jannello, A. Baudo, M. de Angelis, C. Siech, Z. Tian, J.A. Goyal, M. Creta, G. Califano, G. Celentano, P. Acquati, F. Saad, S.F. Shariat, L. Carmignani, O. de Cobelli, A. Briganti, F.K.H. Chun, N. Longo, P.I. Karakiewicz. - In: THE PROSTATE. - ISSN 1097-0045. - (2024), pp. e24816.1-e24816.7. [Epub ahead of print] [10.1002/pros.24816]
Life Expectancy in High-Grade Incidental Prostate Cancer Patients Versus Population-Based Controls According to Treatment Type
L.M.I. JannelloSecondo
;A. Baudo;P. Acquati;L. Carmignani;O. de Cobelli;
2024
Abstract
Objective: To quantify the differences in 5-year overall survival (OS) between high-grade (Gleason sum 8–10) incidental prostate cancer (IPCa) patients and age-matched male population-based controls, according to treatment type: no active versus active treatment. Materials and Methods: We relied on the Surveillance, Epidemiology, and End Results (SEER) database (2004–2015) to identify not actively treated and actively treated high-grade IPCa patients. For each case, we simulated an age-matched male control (Monte Carlo simulation), relying on Social Security Administration Life Tables (2004–2020) with 5 years of follow-up. Additionally, we relied on Kaplan–Meier plots to display OS for each treatment type. Multivariable Cox regression models were fitted to predict overall mortality (OM). Results: Of 564 high-grade IPCa patients, 345 (61%) were not actively treated versus 219 (39%) were actively treated, either with radical prostatectomy or radiotherapy. Median OS was 3 years for not actively treated high-grade IPCa patients, with OS difference at 5 years follow-up of 27% relative to their age-matched male population-based controls (37% vs. 64%). Median OS was 8 years for actively treated high-grade IPCa patients, with OS difference at 5 years follow-up of 6% relative to their age-matched male population-based controls (68% vs. 74%). In the multivariable Cox regression model, active treatment independently predicted lower OM (hazard ratio = 0.6; 95% confidence interval = 0.4–0.8; p < 0.001). Conclusion: Relative to Life Tables' derived age-matched male controls, not actively treated high-grade IPCa patients exhibit drastically worse OS than their actively treated counterparts. These observations may encourage clinicians to consider active treatment in newly diagnosed high-grade IPCa patients.Pubblicazioni consigliate
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