Treatment with curative intent and survival in men with high-risk prostate cancer: A population-based study of 11 380 men with serum PSA level 20-100 ng/mL
2013 (English)In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 111, no 3, 381-388 p.Article in journal (Refereed) Published
Objective To investigate the influence of curative treatment on cause-specific mortality in men diagnosed with prostate cancer (PCa) with serum prostate-specific antigen (PSA) levels between 20 and 100 ng/mL. Materials and Methods Patients with PCa (T1-4, N0/N1/NX, M0/MX), PSA 20-100 ng/mL and age <= 75 years were identified in the National Prostate Cancer Register of Sweden. Data on co-morbidity diagnoses were obtained from the National Patient Register and cause of death from the Cause of Death Register. Following adjustment for age at diagnosis, co-morbidity burden, Gleason score, T-category, PSA level and cause-specific mortality in relation to treatment were estimated using Cox regression analysis. Result A total of 11 380 men were diagnosed with PCa between 1996 and 2008 and fulfilled the inclusion criteria. The cumulative 10-year PCa-specific mortality was 36% for patients receiving only palliative treatment and 13% for those treated with curative intent. For the 8462 (74%) patients with PSA levels from 20 to 50 ng/mL at diagnosis, the hazard ratio for death from PCa was 0.23 (95% confidence interval 0.19-0.27) for those treated with curative intent compared with those given palliative treatment after adjusting for age, co-morbidity, T category, PSA level and Gleason score. The corresponding hazard ratio was 0.22 (95% confidence interval 0.17-0.30) for patients with PSA levels from 51 to 100 ng/mL. Conclusion Treatment with curative intent for men with high-risk PCa was associated with reduced cause-specific mortality and should be considered even when serum PSA exceeds 20 ng/mL. Keywords prostate cancer, prostate-specific antigen, high-risk tumours, curative treatment, palliative treatment, population-based study
Place, publisher, year, edition, pages
2013. Vol. 111, no 3, 381-388 p.
prostate cancer, prostate-specific antigen, high-risk tumours, curative treatment, palliative treatment, population-based study
Cancer and Oncology
IdentifiersURN: urn:nbn:se:umu:diva-67792DOI: 10.1111/j.1464-410X.2012.11320.xISI: 000315395200022OAI: oai:DiVA.org:umu-67792DiVA: diva2:614597