Background: We examined the changes over time in other-cause mortality (OCM) rates in patients with clinically localized prostate cancer (PCa) as an indicator of patient selection. Patients and Methods: Within the Surveillance, Epidemiology, and End Results database (1987-2011), we identified patients with PCa treated with either radical prostatectomy (RP) (n = 230,969; 62.8%) or external beam radiation therapy (EBRT) (n = 136,915; 37.2%). Temporal trends and multivariable Cox regression analyses assessed OCM at 5 years using stratification according to year of diagnosis (1987-1991 vs. 1992-1996 vs. 1997-2001 vs. 2002-2006 vs. 2007-2011), age group, and ethnicity. Results: In patients who had undergone RP, the OCM rates at 5 years of follow-up decreased over time from 7.9% to 2.4% (slope, −0.25%/year) versus from 15.2% to 9.9% after EBRT (slope, −0.29%/year). The greatest decrease in 5-year OCM rates over time was recorded in patients ≥ 75 years (16.0%-12.0%; slope, −0.25%/year), followed by younger age categories (70-74 years, −0.21%/year; 65-69 years, −0.17%/year; 60-64 years, −0.10%/year; < 60 years, −0.07%/year), as well as in African-American men (11.0%-5.1%; slope, −0.32%/year), followed by Caucasian (7.6%-3.4%; slope, −0.21%/year) and Hispanic men (7.0%-3.1%; slope, −0.20%/year; all P <.001), as corroborated in multivariable Cox regression models. Conclusions: OCM rates were highest in oldest individuals and in African-American men. In both groups, an important 5-year OCM reduction over the 25-year study span was recorded. Nonetheless, these 2 patient groups may still represent the ideal target for better patient selection based on OCM considerations, because their most recent OCM rates exceeded those of, respectively, younger and Caucasian patients.
A 25-year Period Analysis of Other-cause Mortality in Localized Prostate Cancer / S. Knipper, A. Pecoraro, C. Palumbo, G. Rosiello, S. Luzzago, Z. Tian, A. Briganti, F. Saad, D. Tilki, M. Graefen, P.I. Karakiewicz. - In: CLINICAL GENITOURINARY CANCER. - ISSN 1558-7673. - 17:5(2019), pp. 395-401. [10.1016/j.clgc.2019.07.008]
|Titolo:||A 25-year Period Analysis of Other-cause Mortality in Localized Prostate Cancer|
|Parole Chiave:||External beam radiation therapy; Life expectancy; Radical prostatectomy; SEER; Survival; Age Factors; Aged; Combined Modality Therapy; Ethnic Groups; Follow-Up Studies; Healthcare Disparities; Humans; Male; Middle Aged; Prognosis; Prostatectomy; Prostatic Neoplasms; Radiotherapy, Intensity-Modulated; Retrospective Studies; Risk Factors; SEER Program; Survival Rate; United States|
|Settore Scientifico Disciplinare:||Settore MED/24 - Urologia|
|Data di pubblicazione:||2019|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.clgc.2019.07.008|
|Appare nelle tipologie:||01 - Articolo su periodico|