Observation, Radiotherapy, or Radical Prostatectomy for Localized Prostate Cancer: Survival Analysis in the United States

Autor: Jang Hee Han, Annika Herlemann, Samuel L. Washington III, Peter E. Lonergan, Peter R. Carroll, Matthew R. Cooperberg, Chang Wook Jeong
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: The World Journal of Men's Health, Vol 41, Iss 4, Pp 940-950 (2023)
Druh dokumentu: article
ISSN: 2287-4208
2287-4690
DOI: 10.5534/wjmh.220151
Popis: Purpose: Contemporary treatment strategies for localized prostate cancer (PCa) have been evolved over time. However, there is little data regarding survival outcomes based on initial treatment by risk group in this new era. This study aims to evaluate survival outcomes among men who underwent observation, radiotherapy, or radical prostatectomy for localized PCa using a population-based cohort. Materials and Methods: The Surveillance, Epidemiology, and End Results (SEER) prostate with watchful waiting dataset (2010– 2016) was used. We included men diagnosed with localized PCa and clinical stage T1c-2cN0M0. Other inclusion criteria were age 50–79 years, prostate-specific antigen (PSA) ≤50 ng/mL, and initial treatment with observation (active surveillance/ watchful waiting), radiotherapy, or radical prostatectomy. PCa risk was assessed using the D’Amico classification. The primary endpoint was overall survival. Secondary endpoints included PCa-specific survival. Inverse probability of treatment weighting (IPTW)-adjusted Cox proportional hazard regression and competing risk analysis were performed to assess outcomes. Results: After IPTW-adjusting, pseudo-population comprised 521,656 men (observation: 170,428, radiotherapy: 175,628, radical prostatectomy: 175,600) at a median 36.5 month follow-up. Observation demonstrated the lowest 5-year overall survival rate (91.6%) after IPTW-adjusting in comparison to radiotherapy (92.4%) and radical prostatectomy (96.1%, p
Databáze: Directory of Open Access Journals
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