Treatment and Mortality in Men with Localized Prostate Cancer: A Population-Based Study in California
Source:Open Prost Cancer J. 6:1-9.
Pubmed Central ID:PMC3758138
Funding:HHSN261201000035C/CA/NCI NIH HHS/United States
U58 DP000807/DP/NCCDPHP CDC HHS/United States
HHSN261201000035I/CA/NCI NIH HHS/United States
K07 CA143047/CA/NCI NIH HHS/United States
HHSN261201000034C/CA/NCI NIH HHS/United States
HHSN261201000040C/CA/NCI NIH HHS/United States
HHSN261201000040I/CA/NCI NIH HHS/United States
To provide patients and physicians with population-based estimates of mortality from prostate cancer or other causes depending upon the primary treatment modality, stratified by patient age, tumor stage and grade.
We conducted a 10-year competing-risk analysis of 45,440 men diagnosed with clinically localized (T1 or T2) prostate cancer in California during 1995–1998. Information on patient characteristics, primary treatment and cause of death was obtained from the California Cancer Registry.
In this population-based cohort, the most common primary treatment was surgery (40.4%), followed by radiotherapy (29.1%), conservative management (20.8%), and androgen deprivation therapy (ADT) monotherapy (9.8%). Prostate cancer mortality differed significantly (p < 0.0001) across treatment groups among patients <80 years at diagnosis with moderately or poorly differentiated disease; the 10-year disease-specific mortality rates were generally highest for men treated with ADT monotherapy [range: 3.3% (95% CI=0.8–12.5%) to 53.8% (95% CI=34.4–72.2%)], intermediate for men treated with conservative management [range: 1.7% (95% CI=0.7–4.6%) to 30.0% (95% CI=16.2–48.8%] or radiotherapy [range: 3.2% (95% CI=1.8–5.5%) to 18.3% (95% CI=15.1–22.0%)], and lowest for men treated with surgery [range: 1.2% (95% CI=0.8–1.7%) to 11.0% (95% CI=8.4–14.2%)].
The cause-specific mortality estimates provided by this observational study can help patients and physicians better understand the expected long-term outcomes of localized prostate cancer given the initial treatment choice and practice patterns in the general population.
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