Is primary androgen deprivation therapy a suitable option for Asian patients with prostate cancer compared with radical prostatectomy?

U. Syn Ha, Jin Bong Choi, Jung Im Shim, Minjoo Kang, Eunjung Park, Shinhee Kang, Jooyeon Park, Jangmi Yang, Insun Choi, Jeonghoon Ahn, Cheol Kwak, Chang Wook Jeong, Choung Soo Kim, Seok Soo Byun, Seong Il Seo, Hyun Moo Lee, Seung Ju Lee, Seung Hwan Lee, Byung Ha Chung, Ji Youl Lee

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: We conducted a comparative survival analysis between primary androgen deprivation therapy (PADT) and radical prostatectomy (RP) based on nationwide Korean population data that included all patients with prostate cancer. Materials and Methods: This study enrolled 4,538 patients with prostate cancer from the National Health Insurance Service (NHIS) database linked with Korean Central Cancer Registry data who were treated with PADT or RP between January 1, 2007, and December 31, 2014. Kaplan-Meier and multivariate survival analyses stratified by stage (localized and locally advanced) and age (,75 and $75 years) were performed using a Cox proportional hazards model to evaluate treatment effects. Results: Among 18,403 patients from the NHIS database diagnosed with prostate cancer during the study period, 4,538 satisfied inclusion criteria and were included in the analyses. Of these, 3,136 and 1,402 patients underwent RP or received PADT, respectively. Risk of death was significantly increased for patients who received PADT compared with those who underwent RP in the propensity score–matched cohort. In subgroup analyses stratified by stage and age, in every subgroup, patients who received PADT had a significantly increased risk of death compared with those who underwent RP. In particular, a much greater risk was observed for patients with locally advanced prostate cancer. Conclusions: Based on a nationwide survival analysis of nonmetastatic prostate cancer, this study provides valuable clinical implications that favor RP over PDAT for treatment of Asian populations. However, the possibility that survival differences have been overestimated due to not accounting for potential confounding characteristics must be considered.

Original languageEnglish
Pages (from-to)441-449
Number of pages9
JournalJNCCN Journal of the National Comprehensive Cancer Network
Volume17
Issue number5
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Prostatectomy
Androgens
Prostatic Neoplasms
National Health Programs
Survival Analysis
Therapeutics
Databases
Proportional Hazards Models
Population
Registries
Multivariate Analysis
Survival
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Ha, U. Syn ; Choi, Jin Bong ; Shim, Jung Im ; Kang, Minjoo ; Park, Eunjung ; Kang, Shinhee ; Park, Jooyeon ; Yang, Jangmi ; Choi, Insun ; Ahn, Jeonghoon ; Kwak, Cheol ; Jeong, Chang Wook ; Kim, Choung Soo ; Byun, Seok Soo ; Seo, Seong Il ; Lee, Hyun Moo ; Lee, Seung Ju ; Lee, Seung Hwan ; Chung, Byung Ha ; Lee, Ji Youl. / Is primary androgen deprivation therapy a suitable option for Asian patients with prostate cancer compared with radical prostatectomy?. In: JNCCN Journal of the National Comprehensive Cancer Network. 2019 ; Vol. 17, No. 5. pp. 441-449.
@article{5e9f06b0e56c4db1a58e3c2e76f32d1c,
title = "Is primary androgen deprivation therapy a suitable option for Asian patients with prostate cancer compared with radical prostatectomy?",
abstract = "Background: We conducted a comparative survival analysis between primary androgen deprivation therapy (PADT) and radical prostatectomy (RP) based on nationwide Korean population data that included all patients with prostate cancer. Materials and Methods: This study enrolled 4,538 patients with prostate cancer from the National Health Insurance Service (NHIS) database linked with Korean Central Cancer Registry data who were treated with PADT or RP between January 1, 2007, and December 31, 2014. Kaplan-Meier and multivariate survival analyses stratified by stage (localized and locally advanced) and age (,75 and $75 years) were performed using a Cox proportional hazards model to evaluate treatment effects. Results: Among 18,403 patients from the NHIS database diagnosed with prostate cancer during the study period, 4,538 satisfied inclusion criteria and were included in the analyses. Of these, 3,136 and 1,402 patients underwent RP or received PADT, respectively. Risk of death was significantly increased for patients who received PADT compared with those who underwent RP in the propensity score–matched cohort. In subgroup analyses stratified by stage and age, in every subgroup, patients who received PADT had a significantly increased risk of death compared with those who underwent RP. In particular, a much greater risk was observed for patients with locally advanced prostate cancer. Conclusions: Based on a nationwide survival analysis of nonmetastatic prostate cancer, this study provides valuable clinical implications that favor RP over PDAT for treatment of Asian populations. However, the possibility that survival differences have been overestimated due to not accounting for potential confounding characteristics must be considered.",
author = "Ha, {U. Syn} and Choi, {Jin Bong} and Shim, {Jung Im} and Minjoo Kang and Eunjung Park and Shinhee Kang and Jooyeon Park and Jangmi Yang and Insun Choi and Jeonghoon Ahn and Cheol Kwak and Jeong, {Chang Wook} and Kim, {Choung Soo} and Byun, {Seok Soo} and Seo, {Seong Il} and Lee, {Hyun Moo} and Lee, {Seung Ju} and Lee, {Seung Hwan} and Chung, {Byung Ha} and Lee, {Ji Youl}",
year = "2019",
month = "1",
day = "1",
doi = "10.6004/jnccn.2018.7265",
language = "English",
volume = "17",
pages = "441--449",
journal = "Journal of the National Comprehensive Cancer Network : JNCCN",
issn = "1540-1405",
publisher = "Cold Spring Publishing LLC",
number = "5",

}

Ha, US, Choi, JB, Shim, JI, Kang, M, Park, E, Kang, S, Park, J, Yang, J, Choi, I, Ahn, J, Kwak, C, Jeong, CW, Kim, CS, Byun, SS, Seo, SI, Lee, HM, Lee, SJ, Lee, SH, Chung, BH & Lee, JY 2019, 'Is primary androgen deprivation therapy a suitable option for Asian patients with prostate cancer compared with radical prostatectomy?', JNCCN Journal of the National Comprehensive Cancer Network, vol. 17, no. 5, pp. 441-449. https://doi.org/10.6004/jnccn.2018.7265

Is primary androgen deprivation therapy a suitable option for Asian patients with prostate cancer compared with radical prostatectomy? / Ha, U. Syn; Choi, Jin Bong; Shim, Jung Im; Kang, Minjoo; Park, Eunjung; Kang, Shinhee; Park, Jooyeon; Yang, Jangmi; Choi, Insun; Ahn, Jeonghoon; Kwak, Cheol; Jeong, Chang Wook; Kim, Choung Soo; Byun, Seok Soo; Seo, Seong Il; Lee, Hyun Moo; Lee, Seung Ju; Lee, Seung Hwan; Chung, Byung Ha; Lee, Ji Youl.

In: JNCCN Journal of the National Comprehensive Cancer Network, Vol. 17, No. 5, 01.01.2019, p. 441-449.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Is primary androgen deprivation therapy a suitable option for Asian patients with prostate cancer compared with radical prostatectomy?

AU - Ha, U. Syn

AU - Choi, Jin Bong

AU - Shim, Jung Im

AU - Kang, Minjoo

AU - Park, Eunjung

AU - Kang, Shinhee

AU - Park, Jooyeon

AU - Yang, Jangmi

AU - Choi, Insun

AU - Ahn, Jeonghoon

AU - Kwak, Cheol

AU - Jeong, Chang Wook

AU - Kim, Choung Soo

AU - Byun, Seok Soo

AU - Seo, Seong Il

AU - Lee, Hyun Moo

AU - Lee, Seung Ju

AU - Lee, Seung Hwan

AU - Chung, Byung Ha

AU - Lee, Ji Youl

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: We conducted a comparative survival analysis between primary androgen deprivation therapy (PADT) and radical prostatectomy (RP) based on nationwide Korean population data that included all patients with prostate cancer. Materials and Methods: This study enrolled 4,538 patients with prostate cancer from the National Health Insurance Service (NHIS) database linked with Korean Central Cancer Registry data who were treated with PADT or RP between January 1, 2007, and December 31, 2014. Kaplan-Meier and multivariate survival analyses stratified by stage (localized and locally advanced) and age (,75 and $75 years) were performed using a Cox proportional hazards model to evaluate treatment effects. Results: Among 18,403 patients from the NHIS database diagnosed with prostate cancer during the study period, 4,538 satisfied inclusion criteria and were included in the analyses. Of these, 3,136 and 1,402 patients underwent RP or received PADT, respectively. Risk of death was significantly increased for patients who received PADT compared with those who underwent RP in the propensity score–matched cohort. In subgroup analyses stratified by stage and age, in every subgroup, patients who received PADT had a significantly increased risk of death compared with those who underwent RP. In particular, a much greater risk was observed for patients with locally advanced prostate cancer. Conclusions: Based on a nationwide survival analysis of nonmetastatic prostate cancer, this study provides valuable clinical implications that favor RP over PDAT for treatment of Asian populations. However, the possibility that survival differences have been overestimated due to not accounting for potential confounding characteristics must be considered.

AB - Background: We conducted a comparative survival analysis between primary androgen deprivation therapy (PADT) and radical prostatectomy (RP) based on nationwide Korean population data that included all patients with prostate cancer. Materials and Methods: This study enrolled 4,538 patients with prostate cancer from the National Health Insurance Service (NHIS) database linked with Korean Central Cancer Registry data who were treated with PADT or RP between January 1, 2007, and December 31, 2014. Kaplan-Meier and multivariate survival analyses stratified by stage (localized and locally advanced) and age (,75 and $75 years) were performed using a Cox proportional hazards model to evaluate treatment effects. Results: Among 18,403 patients from the NHIS database diagnosed with prostate cancer during the study period, 4,538 satisfied inclusion criteria and were included in the analyses. Of these, 3,136 and 1,402 patients underwent RP or received PADT, respectively. Risk of death was significantly increased for patients who received PADT compared with those who underwent RP in the propensity score–matched cohort. In subgroup analyses stratified by stage and age, in every subgroup, patients who received PADT had a significantly increased risk of death compared with those who underwent RP. In particular, a much greater risk was observed for patients with locally advanced prostate cancer. Conclusions: Based on a nationwide survival analysis of nonmetastatic prostate cancer, this study provides valuable clinical implications that favor RP over PDAT for treatment of Asian populations. However, the possibility that survival differences have been overestimated due to not accounting for potential confounding characteristics must be considered.

UR - http://www.scopus.com/inward/record.url?scp=85066239187&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85066239187&partnerID=8YFLogxK

U2 - 10.6004/jnccn.2018.7265

DO - 10.6004/jnccn.2018.7265

M3 - Article

C2 - 31085754

AN - SCOPUS:85066239187

VL - 17

SP - 441

EP - 449

JO - Journal of the National Comprehensive Cancer Network : JNCCN

JF - Journal of the National Comprehensive Cancer Network : JNCCN

SN - 1540-1405

IS - 5

ER -