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Life Expectancy in High-Grade Incidental Prostate Cancer Patients Versus Population-Based Controls According to
Francesco Di Bello1,2, Letizia Maria Ippolita Jannello1,3,4, Andrea Baudo1,4,5
1Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.
The Prostate
|October 25, 2024
Summary
High-grade incidental prostate cancer (IPCa) patients receiving active treatment had significantly better 5-year overall survival (OS) than those not actively treated. Active treatment for high-grade IPCa improves survival outcomes compared to no active treatment.
Area of Science:
- Oncology
- Urology
- Epidemiology
Background:
- High-grade (Gleason sum 8-10) incidental prostate cancer (IPCa) presents a significant clinical challenge.
- Understanding survival differences based on treatment is crucial for patient management.
Purpose of the Study:
- To compare 5-year overall survival (OS) between high-grade IPCa patients and age-matched controls.
- To analyze OS differences based on active versus no active treatment for high-grade IPCa.
Main Methods:
- Utilized the SEER database (2004-2015) for high-grade IPCa patient data.
- Simulated age-matched male controls using Social Security Administration Life Tables.
- Employed Kaplan-Meier plots and multivariable Cox regression for survival analysis.
Main Results:
- Not actively treated patients had a 27% lower 5-year OS (37%) versus controls (64%).
- Actively treated patients had a 6% lower 5-year OS (68%) versus controls (74%).
- Active treatment independently predicted lower overall mortality (HR=0.6, p<0.001).
Conclusions:
- Not actively treated high-grade IPCa patients have drastically worse OS than actively treated counterparts.
- Findings suggest considering active treatment for newly diagnosed high-grade IPCa patients.
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