Long-term survival after radical prostatectomy compared to other treatments in older men with local/regional prostate cancer.
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.
Liu
Liqian
L
School of Public Health, University of Texas Health Science Center, Houston, TX 77030, USA.
Coker
Ann L
AL
Du
Xianglin L
XL
Cormier
Janice N
JN
Ford
Charles E
CE
Fang
Shenying
S
D000368:Aged; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome