title: Population-based 10-year event-free survival after radical prostatectomy for patients with prostate cancer in British Columbia.
abstract: BACKGROUND
  We determined (1) the 10-year survival outcomes after radical treatment of prostate cancer and (2) the 10-year event-free survival following radical prostatectomy (RP) at a population-level in British Columbia (BC), Canada.
  
  
  METHODS
  We identified all men with a new diagnosis of prostate cancer in BC between 1999 and 2000. Those treated with RP, external beam radiotherapy (EBRT) or brachytherapy (BT) were identified. Overall survival, and prostate cancer specific survival (PCSS) were calculated from diagnosis using the Kaplan-Meier method. For those men treated with RP, we calculated the 10-year event-free survival (freedom from salvage EBRT or androgen ablation, or death from prostate cancer). Reasons for initiating androgen therapy were unknown and may include symptomatic metastatic disease or asymptomatic biochemical recurrence. An important limitation was the absence of prostate-specific antigen data for staging or follow-up.
  
  
  RESULTS
  Among 6028 incident cases, RP was the curative-intent treatment within 1 year in 1360 (22.6%) patients, EBRT in 1367 (22.7%), and BT in 357 (5.9%). The 10-year PCSS was 98% for RP, 95% for EBRT and 98% for BT (log rank p < 0.0001). The 10-year overall survival was 87%. The 10-year event-free survival for those treated with RP was 79% and varied with Gleason grade: 87%, 74%, and 52% for Gleason 2-6, 7, and 8-10, respectively (p < 0.0001).
  
  
  CONCLUSIONS
  This population-based study provides outcomes which can inform patient decision-making and provide a benchmark to which other therapies can be compared. Event-free rates for patients treated with RP vary with Gleason score. There is room for improvement in the outcomes of patients with high Gleason score treated with RP.
authors.affiliation: Department of Radiation Oncology, Vancouver Cancer Centre, BC Cancer Agency, Vancouver, BC.
authors.forename: Michael
authors.initials: M
authors.lastname: Peacock
authors.affiliation: Department of Radiation Oncology, Vancouver Cancer Centre, BC Cancer Agency, Vancouver, BC.
authors.forename: Jill
authors.initials: J
authors.lastname: Quirt
authors.affiliation: Department of Radiation Oncology, Vancouver Cancer Centre, BC Cancer Agency, Vancouver, BC.
authors.forename: W
authors.initials: W
authors.lastname: James Morris
authors.affiliation: Department of Radiation Oncology, Vancouver Cancer Centre, BC Cancer Agency, Vancouver, BC.
authors.forename: Alan
authors.initials: A
authors.lastname: So
authors.affiliation: Department of Radiation Oncology, Vancouver Cancer Centre, BC Cancer Agency, Vancouver, BC.
authors.forename: Charmaine Kim
authors.initials: CK
authors.lastname: Sing
authors.affiliation: Department of Radiation Oncology, Vancouver Cancer Centre, BC Cancer Agency, Vancouver, BC.
authors.forename: Tom
authors.initials: T
authors.lastname: Pickles
authors.affiliation: Department of Radiation Oncology, Vancouver Cancer Centre, BC Cancer Agency, Vancouver, BC.
authors.forename: Scott
authors.initials: S
authors.lastname: Tyldesley