Cancer-specific mortality among Korean men with localized or locally advanced prostate cancer treated with radical prostatectomy versus radiotherapy: A multi-center study using propensity scoring and competing risk regression analyses

Kyo Chul Koo, Jin Seon Cho, Woo Jin Bang, Seung Hwan Lee, Sung Yong Cho, Sun Il Kim, Se Joong Kim, Koon Ho Rha, Sung Joon Hong, Byung Ha Chung

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose Studies comparing radical prostatectomy (RP) outcomes with those of radiotherapy with or without androgen deprivation therapy (RT±ADT) for prostate cancer (PCa) have yielded conflicting results. Therefore, we used propensity score-matched analysis and competing risk regression analysis to compare cancer-specific mortality (CSM) and other-cause mortality (OCM) between these two treatments. Materials and Methods The multi-center, Severance Urological Oncology Group registry was utilized to identify 3,028 patients with clinically localized or locally advanced PCa treated by RP (n = 2,521) or RT ± ADT (n = 507) between 2000 and 2016. RT±ADT cases (n=339) were matched with an equal number of RP cases by propensity scoring based on age, preoperative prostate-specific antigen, clinical tumor stage, biopsy Gleason score, and Charlson Comorbidity Index (CCI). CSM and OCM were co-primary endpoints. Results Median follow-up was 65.0 months. Five-year overall survival rates for patients treated with RP and RT±ADT were 94.7% and 92.0%, respectively (p=0.105). Cumulative incidence estimates revealed comparable CSM rates following both treatments within all National Comprehensive Cancer Network risk groups. Gleason score ≥ 8 was associated with higher risk of CSM (p=0.009). OCM rates were comparable between both groups in the low- and intermediate-risk categories (p=0.354 and p=0.643, respectively). For high-risk patients, RT±ADT resulted in higher OCM rates than RP (p=0.011). Predictors of OCM were age ≥ 75 years (p=0.002) and CCI ≥ 2 (p < 0.001). Conclusion RP and RT±ADT provide comparable CSM outcomes in patients with localized or locally advanced PCa. The risk of OCM may be higher for older high-risk patients with significant comorbidities.

Original languageEnglish
Pages (from-to)129-137
Number of pages9
JournalCancer Research and Treatment
Volume50
Issue number1
DOIs
Publication statusPublished - 2018 Jan 1

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Prostatectomy
Prostatic Neoplasms
Radiotherapy
Regression Analysis
Mortality
Neoplasms
Comorbidity
Neoplasm Grading
Propensity Score
Prostate-Specific Antigen
Androgens
Registries
Therapeutics
Survival Rate
Biopsy

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

@article{63ed0b959f9146dbb2de34feb78ec19e,
title = "Cancer-specific mortality among Korean men with localized or locally advanced prostate cancer treated with radical prostatectomy versus radiotherapy: A multi-center study using propensity scoring and competing risk regression analyses",
abstract = "Purpose Studies comparing radical prostatectomy (RP) outcomes with those of radiotherapy with or without androgen deprivation therapy (RT±ADT) for prostate cancer (PCa) have yielded conflicting results. Therefore, we used propensity score-matched analysis and competing risk regression analysis to compare cancer-specific mortality (CSM) and other-cause mortality (OCM) between these two treatments. Materials and Methods The multi-center, Severance Urological Oncology Group registry was utilized to identify 3,028 patients with clinically localized or locally advanced PCa treated by RP (n = 2,521) or RT ± ADT (n = 507) between 2000 and 2016. RT±ADT cases (n=339) were matched with an equal number of RP cases by propensity scoring based on age, preoperative prostate-specific antigen, clinical tumor stage, biopsy Gleason score, and Charlson Comorbidity Index (CCI). CSM and OCM were co-primary endpoints. Results Median follow-up was 65.0 months. Five-year overall survival rates for patients treated with RP and RT±ADT were 94.7{\%} and 92.0{\%}, respectively (p=0.105). Cumulative incidence estimates revealed comparable CSM rates following both treatments within all National Comprehensive Cancer Network risk groups. Gleason score ≥ 8 was associated with higher risk of CSM (p=0.009). OCM rates were comparable between both groups in the low- and intermediate-risk categories (p=0.354 and p=0.643, respectively). For high-risk patients, RT±ADT resulted in higher OCM rates than RP (p=0.011). Predictors of OCM were age ≥ 75 years (p=0.002) and CCI ≥ 2 (p < 0.001). Conclusion RP and RT±ADT provide comparable CSM outcomes in patients with localized or locally advanced PCa. The risk of OCM may be higher for older high-risk patients with significant comorbidities.",
author = "Koo, {Kyo Chul} and Cho, {Jin Seon} and Bang, {Woo Jin} and Lee, {Seung Hwan} and Cho, {Sung Yong} and Kim, {Sun Il} and Kim, {Se Joong} and Rha, {Koon Ho} and Hong, {Sung Joon} and Chung, {Byung Ha}",
year = "2018",
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language = "English",
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pages = "129--137",
journal = "Cancer Research and Treatment",
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publisher = "Korean Cancer Association",
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Cancer-specific mortality among Korean men with localized or locally advanced prostate cancer treated with radical prostatectomy versus radiotherapy : A multi-center study using propensity scoring and competing risk regression analyses. / Koo, Kyo Chul; Cho, Jin Seon; Bang, Woo Jin; Lee, Seung Hwan; Cho, Sung Yong; Kim, Sun Il; Kim, Se Joong; Rha, Koon Ho; Hong, Sung Joon; Chung, Byung Ha.

In: Cancer Research and Treatment, Vol. 50, No. 1, 01.01.2018, p. 129-137.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cancer-specific mortality among Korean men with localized or locally advanced prostate cancer treated with radical prostatectomy versus radiotherapy

T2 - A multi-center study using propensity scoring and competing risk regression analyses

AU - Koo, Kyo Chul

AU - Cho, Jin Seon

AU - Bang, Woo Jin

AU - Lee, Seung Hwan

AU - Cho, Sung Yong

AU - Kim, Sun Il

AU - Kim, Se Joong

AU - Rha, Koon Ho

AU - Hong, Sung Joon

AU - Chung, Byung Ha

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Purpose Studies comparing radical prostatectomy (RP) outcomes with those of radiotherapy with or without androgen deprivation therapy (RT±ADT) for prostate cancer (PCa) have yielded conflicting results. Therefore, we used propensity score-matched analysis and competing risk regression analysis to compare cancer-specific mortality (CSM) and other-cause mortality (OCM) between these two treatments. Materials and Methods The multi-center, Severance Urological Oncology Group registry was utilized to identify 3,028 patients with clinically localized or locally advanced PCa treated by RP (n = 2,521) or RT ± ADT (n = 507) between 2000 and 2016. RT±ADT cases (n=339) were matched with an equal number of RP cases by propensity scoring based on age, preoperative prostate-specific antigen, clinical tumor stage, biopsy Gleason score, and Charlson Comorbidity Index (CCI). CSM and OCM were co-primary endpoints. Results Median follow-up was 65.0 months. Five-year overall survival rates for patients treated with RP and RT±ADT were 94.7% and 92.0%, respectively (p=0.105). Cumulative incidence estimates revealed comparable CSM rates following both treatments within all National Comprehensive Cancer Network risk groups. Gleason score ≥ 8 was associated with higher risk of CSM (p=0.009). OCM rates were comparable between both groups in the low- and intermediate-risk categories (p=0.354 and p=0.643, respectively). For high-risk patients, RT±ADT resulted in higher OCM rates than RP (p=0.011). Predictors of OCM were age ≥ 75 years (p=0.002) and CCI ≥ 2 (p < 0.001). Conclusion RP and RT±ADT provide comparable CSM outcomes in patients with localized or locally advanced PCa. The risk of OCM may be higher for older high-risk patients with significant comorbidities.

AB - Purpose Studies comparing radical prostatectomy (RP) outcomes with those of radiotherapy with or without androgen deprivation therapy (RT±ADT) for prostate cancer (PCa) have yielded conflicting results. Therefore, we used propensity score-matched analysis and competing risk regression analysis to compare cancer-specific mortality (CSM) and other-cause mortality (OCM) between these two treatments. Materials and Methods The multi-center, Severance Urological Oncology Group registry was utilized to identify 3,028 patients with clinically localized or locally advanced PCa treated by RP (n = 2,521) or RT ± ADT (n = 507) between 2000 and 2016. RT±ADT cases (n=339) were matched with an equal number of RP cases by propensity scoring based on age, preoperative prostate-specific antigen, clinical tumor stage, biopsy Gleason score, and Charlson Comorbidity Index (CCI). CSM and OCM were co-primary endpoints. Results Median follow-up was 65.0 months. Five-year overall survival rates for patients treated with RP and RT±ADT were 94.7% and 92.0%, respectively (p=0.105). Cumulative incidence estimates revealed comparable CSM rates following both treatments within all National Comprehensive Cancer Network risk groups. Gleason score ≥ 8 was associated with higher risk of CSM (p=0.009). OCM rates were comparable between both groups in the low- and intermediate-risk categories (p=0.354 and p=0.643, respectively). For high-risk patients, RT±ADT resulted in higher OCM rates than RP (p=0.011). Predictors of OCM were age ≥ 75 years (p=0.002) and CCI ≥ 2 (p < 0.001). Conclusion RP and RT±ADT provide comparable CSM outcomes in patients with localized or locally advanced PCa. The risk of OCM may be higher for older high-risk patients with significant comorbidities.

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