Radical prostatectomy improves survival in selected metastatic prostate cancer patients: A North American population‐based study
Objective To test whether radical prostatectomy might result in better survival than external beam radiation therapy in metastatic prostate cancer patients. Methods Newly diagnosed metastatic prostate cancer patients with M1a/b substages, treated with radical prostatectomy or external beam radiation...
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| Veröffentlicht in: | International journal of urology 2021-08, Vol.28 (8), p.834-839 |
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| creator | Stolzenbach, Lara Franziska Deuker, Marina Collà‐Ruvolo, Claudia Nocera, Luigi Tian, Zhe Maurer, Tobias Steuber, Thomas Tilki, Derya Briganti, Alberto Saad, Fred Chun, Felix KH Graefen, Markus Karakiewicz, Pierre I |
| description | Objective
To test whether radical prostatectomy might result in better survival than external beam radiation therapy in metastatic prostate cancer patients.
Methods
Newly diagnosed metastatic prostate cancer patients with M1a/b substages, treated with radical prostatectomy or external beam radiation therapy were ed from the Surveillance, Epidemiology and End Results database (2004–2016). Temporal trend analyses, propensity score matching, cumulative incidence plots, multivariate competing risks regression models and landmark analyses were used.
Results
Of 4280 patients, 954 (22.3%) were treated with radical prostatectomy. After propensity score matching, 5‐year cancer‐specific mortality was 47.0 versus 53.0% in radical prostatectomy versus external beam radiation therapy patients (P = 0.003). In propensity score matched competing risks regression models, radical prostatectomy was associated with lower cancer‐specific mortality versus external beam radiation therapy (hazard ratio 0.79, 95% confidence interval 0.79–0.90; P = 0.001). Finally, landmark analyses rejected the bias favoring radical prostatectomy. Finally, in subgroup analyses, we relied on selection criteria that most closely resembled the STAMPEDE criteria and a similar hazard ratio of 0.8 (P |
| doi_str_mv | 10.1111/iju.14586 |
| format | Article |
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To test whether radical prostatectomy might result in better survival than external beam radiation therapy in metastatic prostate cancer patients.
Methods
Newly diagnosed metastatic prostate cancer patients with M1a/b substages, treated with radical prostatectomy or external beam radiation therapy were ed from the Surveillance, Epidemiology and End Results database (2004–2016). Temporal trend analyses, propensity score matching, cumulative incidence plots, multivariate competing risks regression models and landmark analyses were used.
Results
Of 4280 patients, 954 (22.3%) were treated with radical prostatectomy. After propensity score matching, 5‐year cancer‐specific mortality was 47.0 versus 53.0% in radical prostatectomy versus external beam radiation therapy patients (P = 0.003). In propensity score matched competing risks regression models, radical prostatectomy was associated with lower cancer‐specific mortality versus external beam radiation therapy (hazard ratio 0.79, 95% confidence interval 0.79–0.90; P = 0.001). Finally, landmark analyses rejected the bias favoring radical prostatectomy. Finally, in subgroup analyses, we relied on selection criteria that most closely resembled the STAMPEDE criteria and a similar hazard ratio of 0.8 (P < 0.001) was recorded.
Conclusion
In metastatic prostate cancer, radical prostatectomy results in lower cancer‐specific mortality relative to external beam radiation therapy. Even after adjustment for age at diagnosis, prostate‐specific antigen and biopsy Gleason grade grouping, lower cancer‐specific mortality rates are recorded in radical prostatectomy patients than in external beam radiation therapy patients. As a result, radical prostatectomy should be considered as a treatment option in selected metastatic prostate cancer patients. However, further validation will be provided by ongoing clinical trials.</description><identifier>ISSN: 0919-8172</identifier><identifier>EISSN: 1442-2042</identifier><identifier>DOI: 10.1111/iju.14586</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc</publisher><subject>Biopsy ; Cancer therapies ; Clinical trials ; Epidemiology ; external beam radiation therapy ; Metastases ; Metastasis ; metastatic prostate cancer ; Mortality ; North American population ; Patients ; Population studies ; Population-based studies ; Prostate cancer ; Prostatectomy ; Radiation hazards ; Radiation therapy ; radical prostatectomy ; Regression analysis ; Survival</subject><ispartof>International journal of urology, 2021-08, Vol.28 (8), p.834-839</ispartof><rights>2021 The Authors. International Journal of Urology published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Urological Association</rights><rights>2021. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3896-1af324a9ac326148ed1abf771eaf76eec1f7dc3de8cbcd769dd25869e49df3d13</citedby><cites>FETCH-LOGICAL-c3896-1af324a9ac326148ed1abf771eaf76eec1f7dc3de8cbcd769dd25869e49df3d13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fiju.14586$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fiju.14586$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,1416,27922,27923,45572,45573</link.rule.ids></links><search><creatorcontrib>Stolzenbach, Lara Franziska</creatorcontrib><creatorcontrib>Deuker, Marina</creatorcontrib><creatorcontrib>Collà‐Ruvolo, Claudia</creatorcontrib><creatorcontrib>Nocera, Luigi</creatorcontrib><creatorcontrib>Tian, Zhe</creatorcontrib><creatorcontrib>Maurer, Tobias</creatorcontrib><creatorcontrib>Steuber, Thomas</creatorcontrib><creatorcontrib>Tilki, Derya</creatorcontrib><creatorcontrib>Briganti, Alberto</creatorcontrib><creatorcontrib>Saad, Fred</creatorcontrib><creatorcontrib>Chun, Felix KH</creatorcontrib><creatorcontrib>Graefen, Markus</creatorcontrib><creatorcontrib>Karakiewicz, Pierre I</creatorcontrib><title>Radical prostatectomy improves survival in selected metastatic prostate cancer patients: A North American population‐based study</title><title>International journal of urology</title><description>Objective
To test whether radical prostatectomy might result in better survival than external beam radiation therapy in metastatic prostate cancer patients.
Methods
Newly diagnosed metastatic prostate cancer patients with M1a/b substages, treated with radical prostatectomy or external beam radiation therapy were ed from the Surveillance, Epidemiology and End Results database (2004–2016). Temporal trend analyses, propensity score matching, cumulative incidence plots, multivariate competing risks regression models and landmark analyses were used.
Results
Of 4280 patients, 954 (22.3%) were treated with radical prostatectomy. After propensity score matching, 5‐year cancer‐specific mortality was 47.0 versus 53.0% in radical prostatectomy versus external beam radiation therapy patients (P = 0.003). In propensity score matched competing risks regression models, radical prostatectomy was associated with lower cancer‐specific mortality versus external beam radiation therapy (hazard ratio 0.79, 95% confidence interval 0.79–0.90; P = 0.001). Finally, landmark analyses rejected the bias favoring radical prostatectomy. Finally, in subgroup analyses, we relied on selection criteria that most closely resembled the STAMPEDE criteria and a similar hazard ratio of 0.8 (P < 0.001) was recorded.
Conclusion
In metastatic prostate cancer, radical prostatectomy results in lower cancer‐specific mortality relative to external beam radiation therapy. Even after adjustment for age at diagnosis, prostate‐specific antigen and biopsy Gleason grade grouping, lower cancer‐specific mortality rates are recorded in radical prostatectomy patients than in external beam radiation therapy patients. As a result, radical prostatectomy should be considered as a treatment option in selected metastatic prostate cancer patients. However, further validation will be provided by ongoing clinical trials.</description><subject>Biopsy</subject><subject>Cancer therapies</subject><subject>Clinical trials</subject><subject>Epidemiology</subject><subject>external beam radiation therapy</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>metastatic prostate cancer</subject><subject>Mortality</subject><subject>North American population</subject><subject>Patients</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Prostate cancer</subject><subject>Prostatectomy</subject><subject>Radiation hazards</subject><subject>Radiation therapy</subject><subject>radical prostatectomy</subject><subject>Regression analysis</subject><subject>Survival</subject><issn>0919-8172</issn><issn>1442-2042</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><recordid>eNp1kctKAzEUhoMoWKsL3yDgRhfTTpK5xV0pXipFQex6SJMzmDI3k5lKd-IT-Iw-iadWXAieTTj5v3Ph_IScsnDEMMZ21Y9YFGfJHhmwKOIBDyO-TwahZDLIWMoPyZH3qzBkgrNsQN4flbFalbR1je9UB7prqg21FeZr8NT3bm3XqNuaeihRBkMr6NQWtvq3jGpVa3C0xV-oO39JJ_S-cd0znVTgcEJN26btS5Sb-vPtY6k8NvJdbzbH5KBQpYeTn3dIFtdXT9PbYP5wM5tO5oEWmUwCpgrBIyWVFjxhUQaGqWWRpgxUkSYAmhWp0cJAppfapIk0huMdJETSFMIwMSTnu76480sPvssr6zWUpaqh6X3OYxElLBaxRPTsD7pqelfjdkjFqQwznmRIXewojUfwDoq8dbZSbpOzMN-6kaMb-bcbyI537KstYfM_mM_uFruKL1H8kJI</recordid><startdate>202108</startdate><enddate>202108</enddate><creator>Stolzenbach, Lara Franziska</creator><creator>Deuker, Marina</creator><creator>Collà‐Ruvolo, Claudia</creator><creator>Nocera, Luigi</creator><creator>Tian, Zhe</creator><creator>Maurer, Tobias</creator><creator>Steuber, Thomas</creator><creator>Tilki, Derya</creator><creator>Briganti, Alberto</creator><creator>Saad, Fred</creator><creator>Chun, Felix KH</creator><creator>Graefen, Markus</creator><creator>Karakiewicz, Pierre I</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope></search><sort><creationdate>202108</creationdate><title>Radical prostatectomy improves survival in selected metastatic prostate cancer patients: A North American population‐based study</title><author>Stolzenbach, Lara Franziska ; Deuker, Marina ; Collà‐Ruvolo, Claudia ; Nocera, Luigi ; Tian, Zhe ; Maurer, Tobias ; Steuber, Thomas ; Tilki, Derya ; Briganti, Alberto ; Saad, Fred ; Chun, Felix KH ; Graefen, Markus ; Karakiewicz, Pierre I</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3896-1af324a9ac326148ed1abf771eaf76eec1f7dc3de8cbcd769dd25869e49df3d13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Biopsy</topic><topic>Cancer therapies</topic><topic>Clinical trials</topic><topic>Epidemiology</topic><topic>external beam radiation therapy</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>metastatic prostate cancer</topic><topic>Mortality</topic><topic>North American population</topic><topic>Patients</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Prostate cancer</topic><topic>Prostatectomy</topic><topic>Radiation hazards</topic><topic>Radiation therapy</topic><topic>radical prostatectomy</topic><topic>Regression analysis</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stolzenbach, Lara Franziska</creatorcontrib><creatorcontrib>Deuker, Marina</creatorcontrib><creatorcontrib>Collà‐Ruvolo, Claudia</creatorcontrib><creatorcontrib>Nocera, Luigi</creatorcontrib><creatorcontrib>Tian, Zhe</creatorcontrib><creatorcontrib>Maurer, Tobias</creatorcontrib><creatorcontrib>Steuber, Thomas</creatorcontrib><creatorcontrib>Tilki, Derya</creatorcontrib><creatorcontrib>Briganti, Alberto</creatorcontrib><creatorcontrib>Saad, Fred</creatorcontrib><creatorcontrib>Chun, Felix KH</creatorcontrib><creatorcontrib>Graefen, Markus</creatorcontrib><creatorcontrib>Karakiewicz, Pierre I</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stolzenbach, Lara Franziska</au><au>Deuker, Marina</au><au>Collà‐Ruvolo, Claudia</au><au>Nocera, Luigi</au><au>Tian, Zhe</au><au>Maurer, Tobias</au><au>Steuber, Thomas</au><au>Tilki, Derya</au><au>Briganti, Alberto</au><au>Saad, Fred</au><au>Chun, Felix KH</au><au>Graefen, Markus</au><au>Karakiewicz, Pierre I</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Radical prostatectomy improves survival in selected metastatic prostate cancer patients: A North American population‐based study</atitle><jtitle>International journal of urology</jtitle><date>2021-08</date><risdate>2021</risdate><volume>28</volume><issue>8</issue><spage>834</spage><epage>839</epage><pages>834-839</pages><issn>0919-8172</issn><eissn>1442-2042</eissn><abstract>Objective
To test whether radical prostatectomy might result in better survival than external beam radiation therapy in metastatic prostate cancer patients.
Methods
Newly diagnosed metastatic prostate cancer patients with M1a/b substages, treated with radical prostatectomy or external beam radiation therapy were ed from the Surveillance, Epidemiology and End Results database (2004–2016). Temporal trend analyses, propensity score matching, cumulative incidence plots, multivariate competing risks regression models and landmark analyses were used.
Results
Of 4280 patients, 954 (22.3%) were treated with radical prostatectomy. After propensity score matching, 5‐year cancer‐specific mortality was 47.0 versus 53.0% in radical prostatectomy versus external beam radiation therapy patients (P = 0.003). In propensity score matched competing risks regression models, radical prostatectomy was associated with lower cancer‐specific mortality versus external beam radiation therapy (hazard ratio 0.79, 95% confidence interval 0.79–0.90; P = 0.001). Finally, landmark analyses rejected the bias favoring radical prostatectomy. Finally, in subgroup analyses, we relied on selection criteria that most closely resembled the STAMPEDE criteria and a similar hazard ratio of 0.8 (P < 0.001) was recorded.
Conclusion
In metastatic prostate cancer, radical prostatectomy results in lower cancer‐specific mortality relative to external beam radiation therapy. Even after adjustment for age at diagnosis, prostate‐specific antigen and biopsy Gleason grade grouping, lower cancer‐specific mortality rates are recorded in radical prostatectomy patients than in external beam radiation therapy patients. As a result, radical prostatectomy should be considered as a treatment option in selected metastatic prostate cancer patients. However, further validation will be provided by ongoing clinical trials.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1111/iju.14586</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | International journal of urology, 2021-08, Vol.28 (8), p.834-839 |
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| subjects | Biopsy Cancer therapies Clinical trials Epidemiology external beam radiation therapy Metastases Metastasis metastatic prostate cancer Mortality North American population Patients Population studies Population-based studies Prostate cancer Prostatectomy Radiation hazards Radiation therapy radical prostatectomy Regression analysis Survival |
| title | Radical prostatectomy improves survival in selected metastatic prostate cancer patients: A North American population‐based study |
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