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Population-based study of disease trajectory after radical treatment for high-risk prostate cancer
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Janssen Global Services, NJ, Titusville, United States.
Janssen Global Services, PA, Horsham, United States.
Janssen Research & Development, CA, Los Angeles, United States.
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2024 (English)In: BJU International, ISSN 1464-4096, E-ISSN 1464-410XArticle in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: To investigate long-term disease trajectories among men with high-risk localized or locally advanced prostate cancer (HRLPC) treated with radical radiotherapy (RT) or radical prostatectomy (RP).

Material and Methods: Men diagnosed with HRLPC in 2006–2020, who received primary RT or RP, were identified from the Prostate Cancer data Base Sweden (PCBaSe) 5.0. Follow-up ended on 30 June 2021. Treatment trajectories and risk of death from prostate cancer (PCa) or other causes were assessed by competing risk analyses using cumulative incidence for each event.

Results: In total, 8317 men received RT and 4923 men underwent RP. The median (interquartile range) follow-up was 6.2 (3.6–9.5) years. After RT, the 10-year risk of PCa-related death was 0.13 (95% confidence interval [CI] 0.12–0.14) and the risk of death from all causes was 0.32 (95% CI 0.31–0.34). After RP, the 10-year risk of PCa-related death was 0.09 (95% CI 0.08–0.10) and the risk of death from all causes was 0.19 (95% CI 0.18–0.21). The 10-year risks of androgen deprivation therapy (ADT) as secondary treatment were 0.42 (95% CI 0.41–0.44) and 0.21 (95% CI 0.20–0.23) after RT and RP, respectively. Among men who received ADT as secondary treatment, the risk of PCa-related death at 10 years after initiation of ADT was 0.33 (95% CI 030–0.36) after RT and 0.27 (95% CI 0.24–0.30) after RP.

Conclusion: Approximately one in 10 men with HRLPC who received primary RT or RP had died from PCa 10 years after diagnosis. Approximately one in three men who received secondary ADT, an indication of PCa progression, died from PCa 10 years after the start of ADT. Early identification and aggressive treatment of men with high risk of progression after radical treatment are warranted.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024.
Keywords [en]
androgen deprivation therapy, disease progression, disease trajectories, mortality, prostate cancer, prostatectomy, radiotherapy
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:umu:diva-224254DOI: 10.1111/bju.16362ISI: 001202606700001PubMedID: 38621388Scopus ID: 2-s2.0-85190946140OAI: oai:DiVA.org:umu-224254DiVA, id: diva2:1857704
Available from: 2024-05-14 Created: 2024-05-14 Last updated: 2024-05-14

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Stattin, PärStyrke, Johan

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