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Urology. 2017 Dec;110:140-147. doi: 10.1016/j.urology.2017.07.048. Epub 2017 Aug 18.

Ten-year Mortality in Men With Nonmetastatic Prostate Cancer in Norway.

Author information

1
Department of Surgery, Vestre Viken Hospital Trust, Bærum Hospital, Drammen, Norway. Electronic address: kirstiaas@hotmail.com.
2
Department of Surgery, Akershus University Hospital, Lørenskog, Norway.
3
Department of Oncology, Haukeland University Hospital, Bergen, Norway; The Cancer Registry of Norway, Norway.
4
The Cancer Registry of Norway, Norway.
5
Department of Pathology, The Norwegian Radium Hospital/Oslo University Hospital, Oslo, Norway.
6
Department of Surgery, Oslo University Hospital, Oslo, Norway.
7
The Cancer Registry of Norway, Norway; Department of Oncology, The Norwegian Radium Hospital/Oslo University Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Norway.

Abstract

OBJECTIVE:

To provide population-based data on 10-year prostate cancer-specific mortality (PCSM), overall mortality (OM), treatment, and prognostic factors in patients with nonmetastatic prostate cancer (PCa).

MATERIALS AND METHODS:

Based on data from the Norwegian Prostate Cancer Registry, we calculated 10-year PCSM and OM in 3449 patients diagnosed with nonmetastatic PCa in 2004-2005 who underwent radical prostatectomy (n = 913), radiotherapy (n = 1334), or no local treatment (n = 1202). Patients were stratified according to risk group, Gleason grade group (GGG), and Eastern Cooperative Oncology Group (ECOG) performance status. Aalen-Johansen and Kaplan-Meier estimates and proportional hazards regressions were used.

RESULTS:

The 10-year PCSM rate was 8.5% (radical prostatectomy: 1.5, radiotherapy: 6.2%, no local treatment: 16.3%) and the OM rate was 25.5%. In the low-risk group, the risk of dying from other causes was 8-fold increased compared with death from PCa, the comparable factor being approximately 2 among high-risk patients. Patients with high-risk factors seemed to benefit the most from local treatment. Within each risk group, the 5 GGGs improved the prediction of PCSM. Having an ECOG performance status of ≥1 doubled the risk of PCSM compared with patients with an ECOG performance status of 0.

CONCLUSION:

For all patients, the 10-year OM was about 3 times higher than PCSM, the greatest and lowest discrepancies emerging among patients with low- and high-risk tumors, respectively. The results support increased use of local treatment in high-risk patients. GGGs should be implemented in clinical practice. The role of ECOG performance status as prognostic factor has to be validated in future studies.

PMID:
28823634
DOI:
10.1016/j.urology.2017.07.048
[Indexed for MEDLINE]

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