TY  - JOUR
A1  - Wenzel, Mike
A1  - Würnschimmel, Christoph
A1  - Chierigo, Francesco
A1  - Tian, Zhe
A1  - Shariat, Shahrokh F.
A1  - Terrone, Carlo
A1  - Saad, Fred
A1  - Tilki, Derya
A1  - Graefen, Markus
A1  - Mandel, Philipp
A1  - Kluth, Luis
A1  - Chun, Felix
A1  - Karakiewicz, Pierre I.
T1  - Non-cancer mortality in elderly prostate cancer patients treated with combination of radical prostatectomy and external beam radiation therapy
T2  - The prostate
N2  - Background: To test for rates of other cause mortality (OCM) and cancer-specific mortality (CSM) in elderly prostate cancer (PCa) patients treated with the combination of radical prostatectomy (RP) and external beam radiation therapy (EBRT) versus RP alone, since elderly PCa patients may be over-treated. Methods: Within the Surveillance, Epidemiology and End Results database (2004–2016), cumulative incidence plots, after propensity score matching for cT-stage, cN-stage, prostate specific antigen, age and biopsy Gleason score, and multivariable competing risks regression models (socioeconomic status, pathological Gleason score) addressed OCM and CSM in patients (70–79, 70–74, and 75–79 years) treated with RP and EBRT versus RP alone. Results: Of 18,126 eligible patients aged 70–79 years, 2520 (13.9%) underwent RP and EBRT versus 15,606 (86.1%) RP alone. After propensity score matching, 10-year OCM rates were respectively 27.9 versus 20.3% for RP and EBRT versus RP alone (p < .001), which resulted in a multivariable HR of 1.4 (p < .001). Moreover, 10-year CSM rates were respectively 13.4 versus 5.5% for RP and EBRT versus RP alone. In subgroup analyses separately addressing 70–74 year old and 75–79 years old PCa patients, 10-year OCM rates were 22.8 versus 16.2% and 39.5 versus 24.0% for respectively RP and EBRT versus RP alone patients (all p < .001). Conclusion: Elderly patients treated with RP and EBRT exhibited worrisome rates of OCM. These higher than expected OCM rates question the need for combination therapy (RP and EBRT) in elderly PCa patients and indicate the need for better patient selection, when combination therapy is contemplated.
KW  - other cause mortality
KW  - overtreatment
KW  - radiation
KW  - radical prostatectomy
KW  - survival
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/63896
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-638966
SN  - 1097-0045
N1  - Open Access funding enabled and organized by Projekt DEAL.
VL  - 81
IS  - 11
SP  - 728
EP  - 735
PB  - Wiley-Liss
CY  - New York, NY
ER  -