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Long‐term survival after radical prostatectomy compared to other treatments in older men with local/regional prostate cancer
Author(s) -
Liu Liqian,
Coker Ann L.,
Du Xianglin L.,
Cormier Janice N.,
Ford Charles E.,
Fang Shenying
Publication year - 2008
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21028
Subject(s) - prostatectomy , medicine , watchful waiting , prostate cancer , urology , hazard ratio , radiation therapy , comorbidity , cohort , population , androgen deprivation therapy , cancer , surgery , confidence interval , environmental health
Background This study aimed to address long‐term survival in a large population‐based cohort of men with prostate cancer receiving radical prostatectomy compared to other treatments. Methods We studied 5,845 patients diagnosed with local/regional stage prostate cancer at age 65–74 in 1992 with comorbidity score <2, who were defined as potential candidates for radical prostatectomy and identified from the SEER (Surveillance, Epidemiology and End Results)‐Medicare cohort with median follow‐up of 11 years. Results Of 5,845 patients, 10‐year all‐cause survival rates were the highest for patients receiving radical prostatectomy (81.0%; 95% CI: 79.4–82.4%), followed by radical prostatectomy in combination with radiotherapy (67.6%; 62.0–72.5%), radiotherapy (60.5%; 58.3–62.6%), and were the lowest for watchful‐waiting (50.7%; 47.5–53.8%). A similar pattern was found for 10‐year prostate cancer‐specific survivals by treatments. After adjusting for age, ethnicity, region, Gleason Score, comorbidity, median annual household income, hormone therapy and chemotherapy, the hazard ratio of all‐cause mortality was 0.31 (95% CI: 0.25–0.37) for radical prostatectomy and 0.38 (95% CI: 0.28–0.52) for radical prostatectomy plus radiation therapy compared to those with watchful‐waiting. Conclusions There was a significant long‐term survival benefit in men receiving radical prostatectomy compared to those receiving watchful‐waiting or radiotherapy. J. Surg. Oncol. 2008;97:583–591. © 2008 Wiley‐Liss, Inc.