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Treatment with curative intent and survival in men with high-risk prostate cancer. A population-based study of 11 380 men with serum PSA level 20-100 ng/mL.

Ladjevardi, Sam ; Berglund, Anders ; Varenhorst, Eberhard ; Bratt, Ola LU ; Widmark, Anders and Sandblom, Gabriel LU (2013) In BJU International 111(3). p.381-388
Abstract
Study Type - Prognosis inception (cohort) Level of Evidence 2 What's known on the subject? and What does the study add? There are two randomized controlled trials showing that radiotherapy can be beneficial for men with locally advanced prostate cancer. The present study confirms the importance of curative treatment for men with high-risk prostate cancer.



OBJECTIVE:

• To investigate the influence of curative treatment on cause-specific mortality in men diagnosed with prostate cancer (PCa) with serum prostate-specific antigen (PSA) levels between 20 and 100 ng/mL.



MATERIALS AND METHODS:

• Patients with PCa (T1-4, N0/N1/NX, M0/MX), PSA 20-100 ng/mL and age ≤75 years were identified... (More)
Study Type - Prognosis inception (cohort) Level of Evidence 2 What's known on the subject? and What does the study add? There are two randomized controlled trials showing that radiotherapy can be beneficial for men with locally advanced prostate cancer. The present study confirms the importance of curative treatment for men with high-risk prostate cancer.



OBJECTIVE:

• To investigate the influence of curative treatment on cause-specific mortality in men diagnosed with prostate cancer (PCa) with serum prostate-specific antigen (PSA) levels between 20 and 100 ng/mL.



MATERIALS AND METHODS:

• Patients with PCa (T1-4, N0/N1/NX, M0/MX), PSA 20-100 ng/mL and age ≤75 years were identified in the National Prostate Cancer Register of Sweden. • Data on co-morbidity diagnoses were obtained from the National Patient Register and cause of death from the Cause of Death Register. • Following adjustment for age at diagnosis, co-morbidity burden, Gleason score, T-category, PSA level and cause-specific mortality in relation to treatment were estimated using Cox regression analysis.



RESULT:

• A total of 11 380 men were diagnosed with PCa between 1996 and 2008 and fulfilled the inclusion criteria. • The cumulative 10-year PCa-specific mortality was 36% for patients receiving only palliative treatment and 13% for those treated with curative intent. • For the 8462 (74%) patients with PSA levels from 20 to 50 ng/mL at diagnosis, the hazard ratio for death from PCa was 0.23 (95% confidence interval 0.19-0.27) for those treated with curative intent compared with those given palliative treatment after adjusting for age, co-morbidity, T category, PSA level and Gleason score. The corresponding hazard ratio was 0.22 (95% confidence interval 0.17-0.30) for patients with PSA levels from 51 to 100 ng/mL.



CONCLUSION:

Treatment with curative intent for men with high-risk PCa was associated with reduced cause-specific mortality and should be considered even when serum PSA exceeds 20 ng/mL. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BJU International
volume
111
issue
3
pages
381 - 388
publisher
Wiley-Blackwell
external identifiers
  • wos:000315395200022
  • pmid:22758210
  • scopus:84874667601
  • pmid:22758210
ISSN
1464-4096
DOI
10.1111/j.1464-410X.2012.11320.x
language
English
LU publication?
yes
id
8acc78ef-81b3-4c16-878c-05e2ee5b6a02 (old id 2967552)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22758210?dopt=Abstract
date added to LUP
2016-04-01 11:02:29
date last changed
2022-01-26 04:53:58
@article{8acc78ef-81b3-4c16-878c-05e2ee5b6a02,
  abstract     = {{Study Type - Prognosis inception (cohort) Level of Evidence 2 What's known on the subject? and What does the study add? There are two randomized controlled trials showing that radiotherapy can be beneficial for men with locally advanced prostate cancer. The present study confirms the importance of curative treatment for men with high-risk prostate cancer. <br/><br>
<br/><br>
OBJECTIVE: <br/><br>
• To investigate the influence of curative treatment on cause-specific mortality in men diagnosed with prostate cancer (PCa) with serum prostate-specific antigen (PSA) levels between 20 and 100 ng/mL. <br/><br>
<br/><br>
MATERIALS AND METHODS: <br/><br>
• Patients with PCa (T1-4, N0/N1/NX, M0/MX), PSA 20-100 ng/mL and age ≤75 years were identified in the National Prostate Cancer Register of Sweden. • Data on co-morbidity diagnoses were obtained from the National Patient Register and cause of death from the Cause of Death Register. • Following adjustment for age at diagnosis, co-morbidity burden, Gleason score, T-category, PSA level and cause-specific mortality in relation to treatment were estimated using Cox regression analysis.<br/><br>
<br/><br>
RESULT: <br/><br>
• A total of 11 380 men were diagnosed with PCa between 1996 and 2008 and fulfilled the inclusion criteria. • The cumulative 10-year PCa-specific mortality was 36% for patients receiving only palliative treatment and 13% for those treated with curative intent. • For the 8462 (74%) patients with PSA levels from 20 to 50 ng/mL at diagnosis, the hazard ratio for death from PCa was 0.23 (95% confidence interval 0.19-0.27) for those treated with curative intent compared with those given palliative treatment after adjusting for age, co-morbidity, T category, PSA level and Gleason score. The corresponding hazard ratio was 0.22 (95% confidence interval 0.17-0.30) for patients with PSA levels from 51 to 100 ng/mL. <br/><br>
<br/><br>
CONCLUSION: <br/><br>
Treatment with curative intent for men with high-risk PCa was associated with reduced cause-specific mortality and should be considered even when serum PSA exceeds 20 ng/mL.}},
  author       = {{Ladjevardi, Sam and Berglund, Anders and Varenhorst, Eberhard and Bratt, Ola and Widmark, Anders and Sandblom, Gabriel}},
  issn         = {{1464-4096}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{381--388}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{BJU International}},
  title        = {{Treatment with curative intent and survival in men with high-risk prostate cancer. A population-based study of 11 380 men with serum PSA level 20-100 ng/mL.}},
  url          = {{http://dx.doi.org/10.1111/j.1464-410X.2012.11320.x}},
  doi          = {{10.1111/j.1464-410X.2012.11320.x}},
  volume       = {{111}},
  year         = {{2013}},
}