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Population-based study of disease trajectory after radical treatment for high-risk prostate cancer

  • 0Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Bju International +

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April 15, 2024

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April 15, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Men with high-risk prostate cancer treated with radical prostatectomy (RP) had a lower risk of death from prostate cancer (PCa) and all causes compared to those treated with radiotherapy (RT). Early identification of progression is crucial.

Area Of Science

  • Oncology
  • Urology
  • Radiotherapy
  • Surgical Oncology

Background

  • High-risk localized or locally advanced prostate cancer (HRLPC) requires effective long-term management strategies.
  • Understanding disease trajectories after radical treatment is crucial for patient outcomes.

Purpose Of The Study

  • To compare long-term disease trajectories in men with HRLPC treated with radical radiotherapy (RT) or radical prostatectomy (RP).

Main Methods

  • Retrospective analysis of 13,240 men diagnosed with HRLPC between 2006-2020 from the Prostate Cancer data Base Sweden (PCBaSe) 5.0.
  • Competing risk analyses using cumulative incidence were performed to assess treatment trajectories and risk of death from prostate cancer (PCa) or other causes.
  • Follow-up extended to June 30, 2021, with a median follow-up of 6.2 years.

Main Results

  • The 10-year risk of PCa-related death was 13% after RT versus 9% after RP. Overall mortality at 10 years was 32% after RT and 19% after RP.
  • The 10-year risk of requiring androgen deprivation therapy (ADT) as secondary treatment was 42% after RT and 21% after RP.
  • Among men receiving ADT, the 10-year risk of PCa-related death after ADT initiation was 33% following RT and 27% following RP.

Conclusions

  • Approximately 10% of men with HRLPC died from PCa within 10 years of diagnosis, regardless of primary treatment (RT or RP).
  • Men requiring secondary ADT, indicating disease progression, faced a significantly higher risk of PCa-related death.
  • Prompt identification and aggressive management of men at high risk of progression post-radical treatment are essential for improving survival outcomes.

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