Title |
Cancer-Specific Mortality Among Korean Men with Localized or Locally Advanced Prostate Cancer Treated with Radical Prostatectomy Versus Radiotherapy: A Multi-Center Study Using Propensity Scoring and Competing Risk Regression Analyses
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Published in |
Cancer Research and Treatment : Official Journal of Korean Cancer Association, March 2017
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DOI | 10.4143/crt.2017.004 |
Pubmed ID | |
Authors |
Kyo Chul Koo, Jin Seon Cho, Woo Jin Bang, Seung Hwan Lee, Sung Yong Cho, Sun Il Kim, Joong Kim, Koon Ho Rha, Sung Joon Hong, Byung Ha Chung |
Abstract |
Studies comparing radical prostatectomy (RP) outcomes with those of radiotherapy with or without androgen deprivation therapy (RT±ADT) for prostate cancer (PCa) have yielded conflicting results. Therefore, we used propensity score-matched analysis and competing risk regression analysis to compare cancer-specific mortality (CSM) and other-cause mortality (OCM) between these two treatments. The multi-center, Severance Urological Oncology Group registry was utilized to identify 3,028 patients with clinically localized or locally advanced PCa treated by RP (n=2,521) or RT±ADT (n=507) between 2000 and 2016. RT±ADT cases (n=339) were matched with an equal number of RP cases by propensity scoring based on age, preoperative prostate-specific antigen, clinical tumor stage, biopsy Gleason score, and Charlson Comorbidity Index (CCI). CSM and OCM were co-primary endpoints. Median follow-up was 65.0 months. Five-year overall survival rates for patients treated with RP and RT±ADT were 94.7% and 92.0%, respectively (p=0.105). Cumulative incidence estimates revealed comparable CSM rates following both treatments within all National Comprehensive Cancer Network risk groups. Gleason score ≥8 was associated with higher risk of CSM (p=0.009). OCM rates were comparable between both groups in the low- and intermediate-risk categories (p=0.354 and p=0.643, respectively). For high-risk patients, RT±ADT resulted in higher OCM rates than RP (p=0.011). Predictors of OCM were age ≥75 years (p=0.002) and CCI ≥2 (p<0.001). RP and RT±ADT provide comparable CSM outcomes in patients with localized or locally advanced PCa. The risk of OCM may be higher for older high-risk patients with significant comorbidities. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 33 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Unspecified | 8 | 24% |
Student > Master | 4 | 12% |
Student > Bachelor | 3 | 9% |
Other | 2 | 6% |
Lecturer | 2 | 6% |
Other | 9 | 27% |
Unknown | 5 | 15% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 9 | 27% |
Unspecified | 8 | 24% |
Computer Science | 3 | 9% |
Nursing and Health Professions | 2 | 6% |
Agricultural and Biological Sciences | 1 | 3% |
Other | 2 | 6% |
Unknown | 8 | 24% |