Discerning the survival advantage among patients with prostate cancer who undergo radical prostatectomy or radiotherapy: The limitations of cancer registry data
| Autor: | Williams, Stephen B, Huo, Jinhai, Chamie, Karim, Smaldone, Marc C, Kosarek, Christopher D, Fang, Justin E, Ynalvez, Leslie A, Kim, Simon P, Hoffman, Karen E, Giordano, Sharon H, Chapin, Brian F |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Urologic Diseases Aging Oncology and Carcinogenesis utilization Information Storage and Retrieval Medicare outcomes survival Cohort Studies 7.1 Individual care needs Clinical Research Cause of Death Humans Registries Oncology & Carcinogenesis Mortality Aetiology Proportional Hazards Models Aged Cancer Prostatectomy Epidemiologic Radiotherapy Prostate Cancer Prostatic Neoplasms Evaluation of treatments and therapeutic interventions United States Confounding Factors Survival Rate Case-Control Studies treatments Public Health and Health Services Patient Safety Management of diseases and conditions 6.4 Surgery SEER Program 2.4 Surveillance and distribution |
| Zdroj: | Cancer, vol 123, iss 9 |
| ISSN: | 1617-1624 |
| Popis: | BackgroundThe objective of this study was to compare the overall survival of patients who undergo radical prostatectomy or radiotherapy versus noncancer controls to discern whether there is a survival advantage according to prostate cancer treatment and the impact of selection bias on these results.MethodsA matched cohort study was performed using the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database. In total, 34,473 patients ages 66 to 75 years were identified who were without significant comorbidity, were diagnosed with localized prostate cancer, and received treatment treated with surgery or radiotherapy between 2004 and 2011. These patients were matched to a noncancer control cohort. The rates of all-cause mortality that occurred within the study period were compared. Cox proportional hazards regression analysis was used to identify determinants associated with overall survival.ResultsOf 34,473 patients who were included in the analysis, 21,740 (63%) received radiation therapy, and 12,733 (37%) underwent surgery. There was improved survival in patients who underwent surgery (hazard ratio, 0.35; 95% confidence interval, 0.32-0.38) and in those who received radiotherapy (hazard ratio, 0.72; 95% confidence interval, 0.68-0.75) compared with noncancer controls. Overall survival improved significantly in both treatment groups, with the greatest benefit observed among patients who underwent surgery (log rank P |
| Databáze: | OpenAIRE |
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