A 25-year Period Analysis of Other-cause Mortality in Localized Prostate Cancer
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A 25-year Period Analysis of Other-cause Mortality in Localized Prostate Cancer. / Knipper, Sophie; Pecoraro, Angela; Palumbo, Carlotta; Rosiello, Giuseppe; Luzzago, Stefano; Tian, Zhe; Briganti, Alberto; Saad, Fred; Tilki, Derya; Graefen, Markus; Karakiewicz, Pierre I.
in: CLIN GENITOURIN CANC, Jahrgang 17, Nr. 5, 10.2019, S. 395-401.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - A 25-year Period Analysis of Other-cause Mortality in Localized Prostate Cancer
AU - Knipper, Sophie
AU - Pecoraro, Angela
AU - Palumbo, Carlotta
AU - Rosiello, Giuseppe
AU - Luzzago, Stefano
AU - Tian, Zhe
AU - Briganti, Alberto
AU - Saad, Fred
AU - Tilki, Derya
AU - Graefen, Markus
AU - Karakiewicz, Pierre I
N1 - Copyright © 2019 Elsevier Inc. All rights reserved.
PY - 2019/10
Y1 - 2019/10
N2 - 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.
AB - 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.
KW - Age Factors
KW - Aged
KW - Combined Modality Therapy
KW - Ethnic Groups/statistics & numerical data
KW - Follow-Up Studies
KW - Healthcare Disparities
KW - Humans
KW - Male
KW - Middle Aged
KW - Prognosis
KW - Prostatectomy/statistics & numerical data
KW - Prostatic Neoplasms/mortality
KW - Radiotherapy, Intensity-Modulated/statistics & numerical data
KW - Retrospective Studies
KW - Risk Factors
KW - SEER Program
KW - Survival Rate
KW - United States/epidemiology
U2 - 10.1016/j.clgc.2019.07.008
DO - 10.1016/j.clgc.2019.07.008
M3 - SCORING: Journal article
C2 - 31416752
VL - 17
SP - 395
EP - 401
JO - CLIN GENITOURIN CANC
JF - CLIN GENITOURIN CANC
SN - 1558-7673
IS - 5
ER -