Ten-year Mortality in Men With Nonmetastatic Prostate Cancer in Norway

Aas, Kirsti; Axcrona, Karol; Kvåle, Rune; Møller, Bjørn; Myklebust, Tor Åge; Axcrona, Ulrika; Berge, Viktor; Fosså, Sophie D.

doi:10.1016/j.urology.2017.07.048

Cited by 10 publications

(8 citation statements)

References 126 publications

(154 reference statements)

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“…Similarly, a previous population‐based study demonstrated reduced 10‐year relative survival in senior adults compared with younger men, with more pronounced differences in high‐risk patients 6 . Unlike previously reported, ECOG status was no longer an independent predictor of PCSM in senior adults when analyzed in a competing risk setting (Table 4, Table S3) 36 . Surprisingly, increasing ISUP grade groups were associated with higher risk of PCa death in younger than in senior men (Table 4).…”

Section: Discussionmentioning

confidence: 61%

Increased curative treatment is associated with decreased prostate cancer‐specific and overall mortality in senior adults with high‐risk prostate cancer; results from a national registry‐based cohort study

et al. 2020

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Background The association between curative treatment (CurTrt) and mortality in senior adults (≥70 years) with high‐risk prostate cancer (PCa) is poorly documented. In a population‐based cohort we report temporal trends in treatment and PCa‐specific mortality (PCSM), investigating the association between CurTrt and mortality in senior adults with high‐risk PCa, compared to findings in younger men (<70 years). Methods Observational study from the Cancer Registry of Norway. Patients with high‐risk PCa were stratified for three diagnostic periods (2005‐08, 2009‐12 and 2013‐16), age (<70, vs ≥70) and primary treatment (CurTrt: Radical prostatectomy (RP), Radiotherapy (RAD) vs no curative treatment (NoCurTrt)). Competing risk and Kaplan‐Meier methods estimated PCSM and overall mortality (OM), respectively. Multivariable logistic regression models estimated odds for CurTrt, and multivariable Fine Gray and Cox regression models evaluated the hazard ratios for PCSM and OM. Results Of 19 763 evaluable patients, 54% were aged ≥70 years. Senior adults had more unfavorable PCa characteristics than younger men. Across diagnostic periods, use of CurTrt increased from 15% to 51% in men aged ≥70 and 65% to 81% in men aged < 70 years. With median five years follow‐up, PCSM decreased in all patients (P < .05), in the third period restricted to senior adults. In all patients NoCurTrt was associated with three‐fold higher 5‐year PCSM and two‐fold higher OM compared to CurTrt. Conclusions In high‐risk PCa patients, increased use of CurTrt, greatest in senior men, was observed along with decreased PCSM and OM in both senior and younger adults. CurTrt should increasingly be considered in men ≥70 years.

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Section: Discussionmentioning

confidence: 61%

Increased curative treatment is associated with decreased prostate cancer‐specific and overall mortality in senior adults with high‐risk prostate cancer; results from a national registry‐based cohort study

et al. 2020

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“…All included studies (Table 1 ) were non-randomized studies, comprising of one prospective population-based cohort study [ 13 ], four retrospective population-based cohort studies [ 14 – 17 ], 10 single-institution retrospective cohort studies [ 18 – 27 ], two multicenter retrospective cohort studies [ 28 , 29 ] and two studies in which data for the two treatment groups came from different (institutional) databases [ 30 , 31 ]. Both cohort studies for which data were collected retrospectively from electronic medical records and studies that analyzed data from existing (institutional) databases were considered retrospective.…”

Section: Resultsmentioning

confidence: 99%

“…The number of included patients varied from approximately 100 to 40,000 and the median follow-up time ranged from approximately 3 to 10 years. Most studies ( n = 11) used the NCCN definition of high-risk PCa [ 15 – 17 , 21 – 27 , 29 ], two studies used the EAU definition [ 14 , 20 ] and in the remaining studies other definitions were used (e.g. Gleason score ≥ 8) [ 13 , 18 , 19 , 28 , 30 , 31 ].…”

Section: Resultsmentioning

confidence: 99%

Radical prostatectomy versus external beam radiotherapy with androgen deprivation therapy for high-risk prostate cancer: a systematic review

et al. 2023

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Background To summarize recent evidence in terms of health-related quality of life (HRQoL), functional and oncological outcomes following radical prostatectomy (RP) compared to external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) for high-risk prostate cancer (PCa). Methods We searched Medline, Embase, Cochrane Database of Systematic Reviews, Cochrane Controlled Trial Register and the International Standard Randomized Controlled Trial Number registry on 29 march 2021. Comparative studies, published since 2016, that reported on treatment with RP versus dose-escalated EBRT and ADT for high-risk non-metastatic PCa were included. The Newcastle–Ottawa Scale was used to appraise quality and risk of bias. A qualitative synthesis was performed. Results Nineteen studies, all non-randomized, met the inclusion criteria. Risk of bias assessment indicated low (n = 14) to moderate/high (n = 5) risk of bias. Only three studies reported functional outcomes and/or HRQoL using different measurement instruments and methods. A clinically meaningful difference in HRQoL was not observed. All studies reported oncological outcomes and survival was generally good (5-year survival rates > 90%). In the majority of studies, a statistically significant difference between both treatment groups was not observed, or only differences in biochemical recurrence-free survival were reported. Conclusions Evidence clearly demonstrating superiority in terms of oncological outcomes of either RP or EBRT combined with ADT is lacking. Studies reporting functional outcomes and HRQoL are very scarce and the magnitude of the effect of RP versus dose-escalated EBRT with ADT on HRQoL and functional outcomes remains largely unknown.

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“…There may be several explanations for the lower 30-day mortality found in PCa patients after an AMI than in the general AMI population. Around 40% of nonmetastatic patients eligible for curative treatment in Norway have T1-localized disease [33]. This indicates that a significant number of patients diagnosed with localized disease are diagnosed as a consequence of PSA testing in asymptomatic men.…”

Section: Discussionmentioning

confidence: 99%

Treatment and 30-Day Mortality after Myocardial Infarction in Prostate Cancer Patients: A Population-Based Study from Norway

et al. 2022

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Introduction: There is limited knowledge about the use of invasive treatment and mortality after acute myocardial infarction (AMI) in prostate cancer patients. We therefore wanted to compare rates of invasive treatment and 30-day mortality between AMIs in patients with prostate cancer (PCa) and AMIs in the general Norwegian male population. Methods: Norwegian population-based registry data from 2013−2019 were used in this cohort study to identify AMIs in patients with a preceding PCa diagnosis. We compared invasive treatment rates and 30-day mortality in AMI patients with PCa to the same outcomes in all male AMI patients in Norway. Invasive treatment was defined as performed angiography with or without percutaneous coronary intervention or coronary artery bypass graft surgery. Standardized mortality (SMR) and incidence ratios (SIR), and logistic regression were used to evaluate the association between PCa risk groups and invasive treatment. Results: In 1018 patients with PCa of all risk groups, the total rates of invasive treatment for AMIs were similar to the rates in the general AMI population. In patients with ST-segment elevation AMIs, rates were lower in metastatic PCa compared to localized PCa (OR 0.15, 95% CI 0.04–0.49). For non-ST-segment elevation AMIs there were no differences between PCa risk groups. The 30-day mortality after AMI was lower in PCa patients than in the total population of similarly aged AMI patients (SMR 0.77, 95% CI 0.61–0.97). Conclusion: Except for patients with metastatic PCa experiencing an ST-segment elevation AMI, PCa patients were treated as frequent with invasive treatment for their AMI as the general AMI population. 30-day all-cause mortality was lower after AMI in PCa patients compared to the general AMI population.

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Ten-year Mortality in Men With Nonmetastatic Prostate Cancer in Norway

Cited by 10 publications

References 126 publications

Increased curative treatment is associated with decreased prostate cancer‐specific and overall mortality in senior adults with high‐risk prostate cancer; results from a national registry‐based cohort study

Increased curative treatment is associated with decreased prostate cancer‐specific and overall mortality in senior adults with high‐risk prostate cancer; results from a national registry‐based cohort study

Radical prostatectomy versus external beam radiotherapy with androgen deprivation therapy for high-risk prostate cancer: a systematic review

Treatment and 30-Day Mortality after Myocardial Infarction in Prostate Cancer Patients: A Population-Based Study from Norway

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