Overall survival and cancer-specific survival were improved in local treatment of metastatic prostate cancer
BackgroundFor metastatic prostate cancer (mPCa), radical prostatectomy (RP) and radiation therapy (RT) may improve overall survival (OS) and cancer-specific survival (CSS). Compared with RT, RP shows significant advantages in improving patient outcomes. External beam radiation therapy (EBRT) even sl...
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| Language: | English |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1130680/full |
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| author | Qi Miao Qi Miao Zhihao Wei Zhihao Wei Chenchen Liu Chenchen Liu Yuzhong Ye Yuzhong Ye Gong Cheng Gong Cheng Zhengshuai Song Kailei Chen Kailei Chen Yunxuan Zhang Yunxuan Zhang Jiawei Chen Jiawei Chen Changjie Yue Changjie Yue Hailong Ruan Hailong Ruan Xiaoping Zhang Xiaoping Zhang |
| author_facet | Qi Miao Qi Miao Zhihao Wei Zhihao Wei Chenchen Liu Chenchen Liu Yuzhong Ye Yuzhong Ye Gong Cheng Gong Cheng Zhengshuai Song Kailei Chen Kailei Chen Yunxuan Zhang Yunxuan Zhang Jiawei Chen Jiawei Chen Changjie Yue Changjie Yue Hailong Ruan Hailong Ruan Xiaoping Zhang Xiaoping Zhang |
| author_sort | Qi Miao |
| collection | DOAJ |
| description | BackgroundFor metastatic prostate cancer (mPCa), radical prostatectomy (RP) and radiation therapy (RT) may improve overall survival (OS) and cancer-specific survival (CSS). Compared with RT, RP shows significant advantages in improving patient outcomes. External beam radiation therapy (EBRT) even slightly elevates CSM with no statistical difference in OS compared with no local treatment (NLT).ObjectiveTo evaluate OS and CSS after local treatment (LT) (including RP and RT) versus NLT in mPCa.Design, setting, and participantsWithin the Surveillance, Epidemiology and End Results (SEER) database (2000-2018), 20098 patients with metastatic prostate cancer were selected in this study, of which 19433 patients had no local treatment, 377 patients with radical prostate treatment, and 288 patients with RT.Outcome measurements and statistical analysisMultivariable competing risks regression analysis after propensity score matching (PSM) was used to calculate CSM. Multivariable Cox regression analysis was used to identify the risk factors. Kaplan-Meier methods were used to calculate OS.Results and limitationsA total of 20098 patients were included: NLT (n = 19433), RP (n=377) and RT (n=288). In a competing risk regression analysis after PSM (ratio 1:1), RP resulted in a significantly lower CSM (hazard ratio [HR] 0.36, 95% confidence interval [CI] 0.29-0.45) than NLT, while RT showed a slightly lower CSM (HR 0.77, 95% CI 0.63-0.95). In a competing risk regression analysis after PSM (ratio 1:1), RP led to a lower CSM (HR 0.56, 95% CI 0.41-0.76) versus RT. As for all-cause mortality (ACM), RP (HR 0.37, 95% CI 0.31-0.45) and RT (HR 0.66, 95% CI 0.56-0.79). also showed a downward trend. In terms of OS, RP and RT significantly improved the survival probability compared with NLT, with the effect of RP being more pronounced. Obviously, older age, Gleason scores ≥8, AJCC T3-T4 stage, AJCC N1, AJCC M1b-M1c were all associated with higher CSM (P <0.05). The same results held true for ACM. The limitation of this article is that it is not possible to assess the effect of differences in systemic therapy on CSM in mPCa patients and clinical trials are needed to verify the results.ConclusionsFor patients with mPCa, both RP and RT are beneficial to patients, and the efficacy of RP is better than RT from the perspective of CSM and ACM. Older age, higher gleason scores and the more advanced AJCC TNM stage all put patients at higher risk of dying.Patient summaryA large population-based cancer database showed that in addition to first-line therapy (hormonal treatment), RP and radiotherapy can also benefit patients with mPCa. |
| first_indexed | 2024-04-09T14:41:56Z |
| format | Article |
| id | doaj.art-0e28b247692f4c88998e15aaee8a36db |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-09T14:41:56Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-0e28b247692f4c88998e15aaee8a36db2023-05-03T05:21:55ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-05-011310.3389/fonc.2023.11306801130680Overall survival and cancer-specific survival were improved in local treatment of metastatic prostate cancerQi Miao0Qi Miao1Zhihao Wei2Zhihao Wei3Chenchen Liu4Chenchen Liu5Yuzhong Ye6Yuzhong Ye7Gong Cheng8Gong Cheng9Zhengshuai Song10Kailei Chen11Kailei Chen12Yunxuan Zhang13Yunxuan Zhang14Jiawei Chen15Jiawei Chen16Changjie Yue17Changjie Yue18Hailong Ruan19Hailong Ruan20Xiaoping Zhang21Xiaoping Zhang22Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaInstitute of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaInstitute of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaInstitute of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaInstitute of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaInstitute of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Urology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaInstitute of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaInstitute of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaInstitute of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaInstitute of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaInstitute of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaInstitute of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaBackgroundFor metastatic prostate cancer (mPCa), radical prostatectomy (RP) and radiation therapy (RT) may improve overall survival (OS) and cancer-specific survival (CSS). Compared with RT, RP shows significant advantages in improving patient outcomes. External beam radiation therapy (EBRT) even slightly elevates CSM with no statistical difference in OS compared with no local treatment (NLT).ObjectiveTo evaluate OS and CSS after local treatment (LT) (including RP and RT) versus NLT in mPCa.Design, setting, and participantsWithin the Surveillance, Epidemiology and End Results (SEER) database (2000-2018), 20098 patients with metastatic prostate cancer were selected in this study, of which 19433 patients had no local treatment, 377 patients with radical prostate treatment, and 288 patients with RT.Outcome measurements and statistical analysisMultivariable competing risks regression analysis after propensity score matching (PSM) was used to calculate CSM. Multivariable Cox regression analysis was used to identify the risk factors. Kaplan-Meier methods were used to calculate OS.Results and limitationsA total of 20098 patients were included: NLT (n = 19433), RP (n=377) and RT (n=288). In a competing risk regression analysis after PSM (ratio 1:1), RP resulted in a significantly lower CSM (hazard ratio [HR] 0.36, 95% confidence interval [CI] 0.29-0.45) than NLT, while RT showed a slightly lower CSM (HR 0.77, 95% CI 0.63-0.95). In a competing risk regression analysis after PSM (ratio 1:1), RP led to a lower CSM (HR 0.56, 95% CI 0.41-0.76) versus RT. As for all-cause mortality (ACM), RP (HR 0.37, 95% CI 0.31-0.45) and RT (HR 0.66, 95% CI 0.56-0.79). also showed a downward trend. In terms of OS, RP and RT significantly improved the survival probability compared with NLT, with the effect of RP being more pronounced. Obviously, older age, Gleason scores ≥8, AJCC T3-T4 stage, AJCC N1, AJCC M1b-M1c were all associated with higher CSM (P <0.05). The same results held true for ACM. The limitation of this article is that it is not possible to assess the effect of differences in systemic therapy on CSM in mPCa patients and clinical trials are needed to verify the results.ConclusionsFor patients with mPCa, both RP and RT are beneficial to patients, and the efficacy of RP is better than RT from the perspective of CSM and ACM. Older age, higher gleason scores and the more advanced AJCC TNM stage all put patients at higher risk of dying.Patient summaryA large population-based cancer database showed that in addition to first-line therapy (hormonal treatment), RP and radiotherapy can also benefit patients with mPCa.https://www.frontiersin.org/articles/10.3389/fonc.2023.1130680/fullmetastatic prostate cancerradical prostatectomyexternal beam radiation therapyradiotherapycancer-specific survival |
| spellingShingle | Qi Miao Qi Miao Zhihao Wei Zhihao Wei Chenchen Liu Chenchen Liu Yuzhong Ye Yuzhong Ye Gong Cheng Gong Cheng Zhengshuai Song Kailei Chen Kailei Chen Yunxuan Zhang Yunxuan Zhang Jiawei Chen Jiawei Chen Changjie Yue Changjie Yue Hailong Ruan Hailong Ruan Xiaoping Zhang Xiaoping Zhang Overall survival and cancer-specific survival were improved in local treatment of metastatic prostate cancer Frontiers in Oncology metastatic prostate cancer radical prostatectomy external beam radiation therapy radiotherapy cancer-specific survival |
| title | Overall survival and cancer-specific survival were improved in local treatment of metastatic prostate cancer |
| title_full | Overall survival and cancer-specific survival were improved in local treatment of metastatic prostate cancer |
| title_fullStr | Overall survival and cancer-specific survival were improved in local treatment of metastatic prostate cancer |
| title_full_unstemmed | Overall survival and cancer-specific survival were improved in local treatment of metastatic prostate cancer |
| title_short | Overall survival and cancer-specific survival were improved in local treatment of metastatic prostate cancer |
| title_sort | overall survival and cancer specific survival were improved in local treatment of metastatic prostate cancer |
| topic | metastatic prostate cancer radical prostatectomy external beam radiation therapy radiotherapy cancer-specific survival |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1130680/full |
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