Francesco Chierigo, Marco Borghesi, Christoph Würnschimmel, Rocco S. Flammia, Benedikt Horlemann, Gabriele Sorce, Robert Benedikt Höh, Zhe Tian, Fred Saad, Markus Graefen, Michele Gallucci, Alberto Briganti, Francesco Montorsi, Felix Chun, Shahrokh F. Shariat, Guglielmo Mantica, Nazareno Suardi, Carlo Terrone, Pierre I. Karakiewicz
- Aim
To compare overall mortality (OM), cancer-specific mortality (CSM), and other cause mortality (OCM) rates between radical prostatectomy (RP) versus radiotherapy (RT) in clinical node-positive (cN1) prostate cancer (PCa).
Materials and Methods
Within Surveillance, Epidemiology, End Results (SEER) (2004–2016), we identified 4685 cN1 PCa patients, of whom 3589 (76.6%) versus 1096 (24.4%) were treated with RP versus RT. After 1:1 propensity score matching (PSM), Kaplan–Meier plots and Cox regression models tested the effect of RP versus RT on OM, while cumulative incidence plots and competing-risks regression (CRR) models addressed CSM and OCM between RP and RT patients. All analyses were repeated after the inverse probability of treatment weighting (IPTW). For CSM and OCM analyses, the propensity score was used as a covariate in the regression model.
Results
Overall, RT patients were older, harbored higher prostate-specific antigen values, higher clinical T and higher Gleason grade groups. PSM resulted in two equally sized groups of 894 RP versus 894 RT patients. After PSM, 5-year OM, CSM, and OCM rates were, respectively, 15.4% versus 25%, 9.3% versus 17%, and 6.1% versus 8% for RP versus RT (all p < 0.001) and yielded respective multivariate hazard ratios (HRs) of 0.63 (0.52–0.78, p < 0.001), 0.66 (0.52–0.86, p < 0.001), 0.71 (0.5–1.0, p = 0.05), all favoring RP. After IPTW, Cox regression models yielded HR of 0.55 (95% confidence interval [CI] = 0.46–0.66) for OM, and CRR yielded HRs of 0.49 (0.34–0.70) and 0.54 (0.36–0.79) for, respectively, CSM and OCM, all favoring RP (all p < 0.001).
Conclusions
RP may hold a CSM advantage over RT in cN1 PCa patients.
MetadatenVerfasserangaben: | Francesco ChierigoORCiD, Marco Borghesi, Christoph WürnschimmelORCiDGND, Rocco S. FlammiaORCiD, Benedikt Horlemann, Gabriele Sorce, Robert Benedikt HöhORCiDGND, Zhe Tian, Fred SaadORCiDGND, Markus GraefenGND, Michele Gallucci, Alberto BrigantiORCiD, Francesco MontorsiGND, Felix ChunORCiDGND, Shahrokh F. ShariatORCiDGND, Guglielmo Mantica, Nazareno Suardi, Carlo TerroneORCiDGND, Pierre I. Karakiewicz |
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URN: | urn:nbn:de:hebis:30:3-751402 |
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DOI: | https://doi.org/10.1002/pros.24317 |
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ISSN: | 1097-0045 |
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Titel des übergeordneten Werkes (Englisch): | The prostate |
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Verlag: | Wiley-Liss |
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Verlagsort: | New York, NY |
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Dokumentart: | Wissenschaftlicher Artikel |
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Sprache: | Englisch |
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Datum der Veröffentlichung (online): | 28.02.2022 |
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Datum der Erstveröffentlichung: | 28.02.2022 |
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Veröffentlichende Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Datum der Freischaltung: | 15.07.2024 |
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Freies Schlagwort / Tag: | clinical node positive; external beam radiotherapy; prostate cancer; radical prostatectomy |
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Jahrgang: | 82 |
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Ausgabe / Heft: | 6 |
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Seitenzahl: | 11 |
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Erste Seite: | 740 |
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Letzte Seite: | 750 |
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Bemerkung: | Open access funding provided by Universita degli Studi di Genova within the CRUI-CARE Agreement. |
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Institute: | Medizin |
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DDC-Klassifikation: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Lizenz (Deutsch): | Creative Commons - CC BY-NC - Namensnennung - Nicht kommerziell 4.0 International |
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