Prognostic impact of definitive local therapy of the primary tumor in men with metastatic prostate cancer at diagnosis: A population-based, propensity score analysis

Samuel Antwi, Todd M. Everson

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background: This study investigated whether definitive local therapy [radical prostatectomy (RP) or brachytherapy (BT)] of the primary tumor improves survival in men with metastatic prostate cancer (PrCA) at diagnosis. Methods: Data on newly diagnosed metastatic PrCA cases (stage IV, N= 7858) were obtained from the Surveillance Epidemiology and End Results (SEER) program. Conventional multivariable survival analysis and propensity score analysis were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (95% CI) comparing men who underwent definitive local therapy of the primary tumor to those who did not. Results: After adjusting for sociodemographic and tumor attributes, having RP after diagnosis with metastatic PrCA was associated with 73% (HR. = 0.27, 95% CI: 0.20-0.38) lower risk of all-cause mortality and 72% (HR. = 0.28, 95% CI: 0.20-0.39) reduced risk of death from PrCA. Having BT also was associated with 57% (HR. = 0.43, 95% CI: 0.31-0.59) and 54% (HR. = 0.46, 95% CI: 0.33-0.64) lower risk of all-cause and PrCA-specific mortality. Similar results were observed in propensity score-adjusted analysis as well as when stratified by age and extent of tumor metastasis. Conclusions: These findings suggest that definitive local therapy improves survival in men with metastatic PrCA at diagnosis. Future work should consider comorbidities, diet, physical activity and smoking status.

Original languageEnglish (US)
Pages (from-to)435-441
Number of pages7
JournalCancer Epidemiology
Volume38
Issue number4
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Propensity Score
Prostatic Neoplasms
Confidence Intervals
Population
Neoplasms
Brachytherapy
Prostatectomy
Therapeutics
SEER Program
Survival
Mortality
Survival Analysis
Comorbidity
Smoking
Exercise
Neoplasm Metastasis
Diet

Keywords

  • Definitive therapy
  • Metastasis
  • Prostate cancer
  • SEER data
  • Stage IV prostate cancer
  • Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Epidemiology
  • Medicine(all)

Cite this

@article{b634e5265a9e4de1a85d9b909e9b8e8c,
title = "Prognostic impact of definitive local therapy of the primary tumor in men with metastatic prostate cancer at diagnosis: A population-based, propensity score analysis",
abstract = "Background: This study investigated whether definitive local therapy [radical prostatectomy (RP) or brachytherapy (BT)] of the primary tumor improves survival in men with metastatic prostate cancer (PrCA) at diagnosis. Methods: Data on newly diagnosed metastatic PrCA cases (stage IV, N= 7858) were obtained from the Surveillance Epidemiology and End Results (SEER) program. Conventional multivariable survival analysis and propensity score analysis were used to estimate hazard ratios (HRs) and corresponding 95{\%} confidence intervals (95{\%} CI) comparing men who underwent definitive local therapy of the primary tumor to those who did not. Results: After adjusting for sociodemographic and tumor attributes, having RP after diagnosis with metastatic PrCA was associated with 73{\%} (HR. = 0.27, 95{\%} CI: 0.20-0.38) lower risk of all-cause mortality and 72{\%} (HR. = 0.28, 95{\%} CI: 0.20-0.39) reduced risk of death from PrCA. Having BT also was associated with 57{\%} (HR. = 0.43, 95{\%} CI: 0.31-0.59) and 54{\%} (HR. = 0.46, 95{\%} CI: 0.33-0.64) lower risk of all-cause and PrCA-specific mortality. Similar results were observed in propensity score-adjusted analysis as well as when stratified by age and extent of tumor metastasis. Conclusions: These findings suggest that definitive local therapy improves survival in men with metastatic PrCA at diagnosis. Future work should consider comorbidities, diet, physical activity and smoking status.",
keywords = "Definitive therapy, Metastasis, Prostate cancer, SEER data, Stage IV prostate cancer, Survival",
author = "Samuel Antwi and Everson, {Todd M.}",
year = "2014",
doi = "10.1016/j.canep.2014.04.002",
language = "English (US)",
volume = "38",
pages = "435--441",
journal = "Cancer Epidemiology",
issn = "1877-7821",
publisher = "Elsevier BV",
number = "4",

}

TY - JOUR

T1 - Prognostic impact of definitive local therapy of the primary tumor in men with metastatic prostate cancer at diagnosis

T2 - A population-based, propensity score analysis

AU - Antwi, Samuel

AU - Everson, Todd M.

PY - 2014

Y1 - 2014

N2 - Background: This study investigated whether definitive local therapy [radical prostatectomy (RP) or brachytherapy (BT)] of the primary tumor improves survival in men with metastatic prostate cancer (PrCA) at diagnosis. Methods: Data on newly diagnosed metastatic PrCA cases (stage IV, N= 7858) were obtained from the Surveillance Epidemiology and End Results (SEER) program. Conventional multivariable survival analysis and propensity score analysis were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (95% CI) comparing men who underwent definitive local therapy of the primary tumor to those who did not. Results: After adjusting for sociodemographic and tumor attributes, having RP after diagnosis with metastatic PrCA was associated with 73% (HR. = 0.27, 95% CI: 0.20-0.38) lower risk of all-cause mortality and 72% (HR. = 0.28, 95% CI: 0.20-0.39) reduced risk of death from PrCA. Having BT also was associated with 57% (HR. = 0.43, 95% CI: 0.31-0.59) and 54% (HR. = 0.46, 95% CI: 0.33-0.64) lower risk of all-cause and PrCA-specific mortality. Similar results were observed in propensity score-adjusted analysis as well as when stratified by age and extent of tumor metastasis. Conclusions: These findings suggest that definitive local therapy improves survival in men with metastatic PrCA at diagnosis. Future work should consider comorbidities, diet, physical activity and smoking status.

AB - Background: This study investigated whether definitive local therapy [radical prostatectomy (RP) or brachytherapy (BT)] of the primary tumor improves survival in men with metastatic prostate cancer (PrCA) at diagnosis. Methods: Data on newly diagnosed metastatic PrCA cases (stage IV, N= 7858) were obtained from the Surveillance Epidemiology and End Results (SEER) program. Conventional multivariable survival analysis and propensity score analysis were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (95% CI) comparing men who underwent definitive local therapy of the primary tumor to those who did not. Results: After adjusting for sociodemographic and tumor attributes, having RP after diagnosis with metastatic PrCA was associated with 73% (HR. = 0.27, 95% CI: 0.20-0.38) lower risk of all-cause mortality and 72% (HR. = 0.28, 95% CI: 0.20-0.39) reduced risk of death from PrCA. Having BT also was associated with 57% (HR. = 0.43, 95% CI: 0.31-0.59) and 54% (HR. = 0.46, 95% CI: 0.33-0.64) lower risk of all-cause and PrCA-specific mortality. Similar results were observed in propensity score-adjusted analysis as well as when stratified by age and extent of tumor metastasis. Conclusions: These findings suggest that definitive local therapy improves survival in men with metastatic PrCA at diagnosis. Future work should consider comorbidities, diet, physical activity and smoking status.

KW - Definitive therapy

KW - Metastasis

KW - Prostate cancer

KW - SEER data

KW - Stage IV prostate cancer

KW - Survival

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U2 - 10.1016/j.canep.2014.04.002

DO - 10.1016/j.canep.2014.04.002

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JO - Cancer Epidemiology

JF - Cancer Epidemiology

SN - 1877-7821

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