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Survival of men with clinically localized prostate cancer treated with prostatectomy, brachytherapy, or no definitive treatment
Author(s) -
Tward Jonathan D.,
Lee Christopher M.,
Pappas Lisa M.,
Szabo Aniko,
Gaffney David K.,
Shrieve Dennis C.
Publication year - 2006
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.22261
Subject(s) - medicine , brachytherapy , prostate cancer , prostatectomy , multivariate analysis , stage (stratigraphy) , univariate analysis , cancer , prostate , oncology , radiation therapy , surgery , gynecology , urology , biology , paleontology
BACKGROUND. The optimal treatment for men with early stage prostate cancer remains undefined. Survival of such patients after surgery, brachytherapy, or no definitive therapy was investigated specifically to determine the impact of age at diagnosis. METHODS. In all, 60,290 men diagnosed with organ‐confined, low and moderate grade prostate cancer between 1988 and 2002 were retrospectively identified from centers participating in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program. Prostate cancer‐specific mortality (PCSM) and any‐cause mortality (ACM) were determined. Outcomes for patients treated by brachytherapy, surgery, or receiving no definitive treatment were compared using the Wilcoxon test, stratified by T‐stage and grade, and using multivariate analysis. RESULTS. The median follow‐up time was 46 months (range, 0–189 months). For men under age 60 at diagnosis, PCSM at 10 years was 1.3%, 0.5%, and 3.7% for surgery, brachytherapy, and no definitive therapy, respectively. For men age 60 and older the PCSM was 3.8%, 5.3%, and 8.4%, respectively. On univariate and multivariate analysis, surgery and brachytherapy resulted in statistically equivalent PCSM and ACM, and both had a significantly lower PCSM and ACM versus no definitive therapy. CONCLUSIONS. A better survival was observed in men treated with a definitive therapy. The magnitude of the benefit on PCSM or ACM was similar for both definitive therapies irrespective of age. Cancer 2006. © 2006 American Cancer Society.