Journal article
The risk of prostate cancer mortality and cardiovascular mortality of nonmetastatic prostate cancer patients: A population-based retrospective cohort study.
- Matthes KL Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland; Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland. Electronic address: katarinaluise.matthes@usz.ch.
- Pestoni G Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland; Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland.
- Korol D Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland.
- Van Hemelrijck M Division of Cancer Studies, Translational Oncology & Urology Research (TOUR), King's College London, London, United Kingdom.
- Rohrmann S Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland; Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland.
- 2018-03-27
Published in:
- Urologic oncology. - 2018
ADT
Cancer registry
Cause-Specific Mortality
Prostate cancer
Survival analysis
Treatment
Aged
Cardiovascular Diseases
Cause of Death
Combined Modality Therapy
Follow-Up Studies
Humans
Male
Middle Aged
Prognosis
Prostatic Neoplasms
Retrospective Studies
Risk Factors
Survival Rate
English
PURPOSE
To assess the risk of prostate cancer (PCa) specific mortality (PCSM) compared to cardiovascular disease mortality (CVDM), or other-cause mortality (OCM) of men with nonmetastatic PCa according to PCa risk groups, primary treatment, and age.
PATIENTS AND METHODS
This retrospective population-based cohort study identified 1,908 nonmetastatic PCa patients in the cancer registry Zurich and Zug, diagnosed between 2000 and 2009 living in the City of Zurich. Multiple imputation methods were applied to handle missing PCa information. Fine and Gray competing risk regression analysis was used to estimate subdistribution hazard ratios for the outcomes PCSM, CVDM, or OCM RESULTS: Ten years after diagnosis the cumulative probability of PCSM and CVDM was 16.4% and 10.0%, respectively. We observed an increased adjusted risk of PCSM in men treated with androgen deprivation therapy (ADT) compared to surgery, but could not observe an association between ADT and CVDM. The probability of PCSM was significantly higher for patients on active surveillance or watchful waiting, compared to surgery. Age and PCa risk categories were positively associated with risk of PCSM, whereas there was no evidence for an association with CVDM or OCM based on risk groups.
CONCLUSIONS
Overall, men with PCa were more likely to die from non-PCa related outcomes. Nevertheless, the analyses showed a high proportion of PCSM among men on ADT, older men and men with a high-risk tumor. However, further research is needed to understand comprehensively the benefits of the respective treatments.
To assess the risk of prostate cancer (PCa) specific mortality (PCSM) compared to cardiovascular disease mortality (CVDM), or other-cause mortality (OCM) of men with nonmetastatic PCa according to PCa risk groups, primary treatment, and age.
PATIENTS AND METHODS
This retrospective population-based cohort study identified 1,908 nonmetastatic PCa patients in the cancer registry Zurich and Zug, diagnosed between 2000 and 2009 living in the City of Zurich. Multiple imputation methods were applied to handle missing PCa information. Fine and Gray competing risk regression analysis was used to estimate subdistribution hazard ratios for the outcomes PCSM, CVDM, or OCM RESULTS: Ten years after diagnosis the cumulative probability of PCSM and CVDM was 16.4% and 10.0%, respectively. We observed an increased adjusted risk of PCSM in men treated with androgen deprivation therapy (ADT) compared to surgery, but could not observe an association between ADT and CVDM. The probability of PCSM was significantly higher for patients on active surveillance or watchful waiting, compared to surgery. Age and PCa risk categories were positively associated with risk of PCSM, whereas there was no evidence for an association with CVDM or OCM based on risk groups.
CONCLUSIONS
Overall, men with PCa were more likely to die from non-PCa related outcomes. Nevertheless, the analyses showed a high proportion of PCSM among men on ADT, older men and men with a high-risk tumor. However, further research is needed to understand comprehensively the benefits of the respective treatments.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.urolonc.2018.02.016
- PMID 29576269
- Persistent URL
- https://sonar.ch/global/documents/47493
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