The impact of radical prostatectomy versus radiation therapy on cancer-specific-mortality for non-metastatic prostate cancer: Analysis of an other-cause-mortality matched cohort
Recommended Citation
Finati M, Corsi NJ, Chiarelli G, Cirulli GO, Stephens A, Tinsley S, Davis M, Butaney M, Arora S, Sood A, Buffi NM, Lughezzani G, Briganti A, Salonia A, Montorsi F, Bettocchi C, Carrieri G, Rogers CG, Abdollah F. The impact of radical prostatectomy versus radiation therapy on cancer-specific-mortality for non-metastatic prostate cancer: Analysis of an other-cause-mortality matched cohort. Eur Urol 2024; 85:S1273-S1274.
Document Type
Conference Proceeding
Publication Date
3-1-2024
Publication Title
Eur Urol
Keywords
chlordiazepoxide, adult, aged, cancer mortality, cohort analysis, conference abstract, controlled study, Gleason score, high risk population, human, major clinical study, male, metastasis, metastatic prostate cancer, mortality, propensity score, radical prostatectomy, radiotherapy, surgery
Abstract
Introduction & Objectives: Studies comparing radical prostatectomy (RP) to radiation therapy (RT) have consistently shown that patients undergoing RT have a higher risk of other-cause mortality (OCM) compared to RP, signifying poor health status of the former patients. We aimed to evaluate the impact of RP vs RT on cancer-specific mortality (CSM) over a cohort with equivalent OCM risk. Materials & Methods: The Surveillance, Epidemiology and End Results (SEER) database was queried to identify patients diagnosed with non-metastatic PCa between 2004-2009, treated with RP or RT. A Cox-regression model was used to calculate the 10-year OCM risk. Propensity-scores based on the calculated OCM risk were used to match RP and RT patients. Cumulative incidence curves and multivariable Fine-Gray regression analyses were used to examine the impact of type on CSM in the matched cohort. Results: We identified 55,106 PCa patients treated with RP and 36,674 treated with RT. After match, 6,506 patients were equally distributed for RT vs RP, with no difference in OCM rates (p=0.2). After stratifying the matched cohort for D'Amico risk and Gleason Score, 10-year CSM rates were 8.8% vs 0.6% (p=0.01) for RT vs RP in patients with unfavorable-intermediate-risk (Gleason Score 4+3) and 7.9% vs 3.9% (p=0.003) for high-risk disease. There was no difference in CSM rates among RT and RP patients for favorable-intermediate-risk (Gleason Score 3+4) and low-risk disease. Conclusions: In a matched cohort of PCa patients with comparable OCM between the two arms, RP yielded a more favorable CSM rate compared to RT only for unfavorable-intermediate- and high-risk groups. [Figure presented]
Volume
85
First Page
S1273
Last Page
S1274
