Treatment and Mortality in Men with Localized Prostate Cancer: A Population-Based Study in California.

The open prostate cancer journal Pub Date : 2013-01-01
Weiva Sieh, Daphne Y Lichtensztajn, David O Nelson, Myles Cockburn, Dee W West, James D Brooks, Ellen T Chang
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Abstract

Purpose: To provide patients and physicians with population-based estimates of mortality from prostate cancer or other causes depending upon the primary treatment modality, stratified by patient age, tumor stage and grade.

Methods: We conducted a 10-year competing-risk analysis of 45,440 men diagnosed with clinically localized (T1 or T2) prostate cancer in California during 1995-1998. Information on patient characteristics, primary treatment and cause of death was obtained from the California Cancer Registry.

Results: In this population-based cohort, the most common primary treatment was surgery (40.4%), followed by radiotherapy (29.1%), conservative management (20.8%), and androgen deprivation therapy (ADT) monotherapy (9.8%). Prostate cancer mortality differed significantly (p < 0.0001) across treatment groups among patients <80 years at diagnosis with moderately or poorly differentiated disease; the 10-year disease-specific mortality rates were generally highest for men treated with ADT monotherapy [range: 3.3% (95% CI=0.8-12.5%) to 53.8% (95% CI=34.4-72.2%)], intermediate for men treated with conservative management [range: 1.7% (95% CI=0.7-4.6%) to 30.0% (95% CI=16.2-48.8%] or radiotherapy [range: 3.2% (95% CI=1.8-5.5%) to 18.3% (95% CI=15.1-22.0%)], and lowest for men treated with surgery [range: 1.2% (95% CI=0.8-1.7%) to 11.0% (95% CI=8.4-14.2%)].

Conclusion: The cause-specific mortality estimates provided by this observational study can help patients and physicians better understand the expected long-term outcomes of localized prostate cancer given the initial treatment choice and practice patterns in the general population.

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男性局限性前列腺癌症的治疗和死亡率:加利福尼亚州基于人群的研究。
目的:根据主要治疗方式,根据患者年龄、肿瘤分期和分级,为患者和医生提供基于人群的癌症或其他原因的死亡率估计。方法:我们对1995年至1998年在加利福尼亚州诊断为临床局限性(T1或T2)前列腺癌症的45440名男性进行了为期10年的竞争风险分析。从加州癌症登记处获得有关患者特征、主要治疗和死因的信息。结果:在这一基于人群的队列中,最常见的主要治疗是手术(40.4%),其次是放疗(29.1%)、保守治疗(20.8%)、,和雄激素剥夺疗法(ADT)单药治疗(9.8%)。不同治疗组患者的前列腺癌症死亡率差异显著(p<0.0001)普通人群的实践模式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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