Trends and outcome from radical therapy for primary non-metastatic prostate cancer in a UK population.
Increasing proportions of men diagnosed with prostate cancer in the UK are presenting with non-metastatic disease. We investigated how treatment trends in this demographic have changed.Non-metastatic cancers diagnosed from 2000-2010 in the UK Anglian Cancer network stratified by age and risk group w...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2015-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4351083?pdf=render |
| _version_ | 1811230173632135168 |
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| author | David C Greenberg Artitaya Lophatananon Karen A Wright Kenneth R Muir Vincent J Gnanapragasam |
| author_facet | David C Greenberg Artitaya Lophatananon Karen A Wright Kenneth R Muir Vincent J Gnanapragasam |
| author_sort | David C Greenberg |
| collection | DOAJ |
| description | Increasing proportions of men diagnosed with prostate cancer in the UK are presenting with non-metastatic disease. We investigated how treatment trends in this demographic have changed.Non-metastatic cancers diagnosed from 2000-2010 in the UK Anglian Cancer network stratified by age and risk group were analysed [n = 10,365]. Radiotherapy [RT] and prostatectomy [RP] cancer specific survival [CSS] were further compared [n = 4755].Over the decade we observed a fall in uptake of primary androgen deprivation therapy but a rise in conservative management [CM] and radical therapy [p<0.0001]. CM in particular has become the primary management for low-risk disease by the decade end [p<0.0001]. In high-risk disease however both RP and RT uptake increased significantly but in an age dependent manner [p<0.0001]. Principally, increased RP in younger men and increased RT in men ≥ 70y. In multivariate analysis of radically treated men both high-risk disease [HR 8.0 [2.9-22.2], p<0.0001] and use of RT [HR 1.9 [1.0-3.3], p = 0.024] were significant predictors of a poorer CSM. In age-stratified analysis however, the trend to benefit of RP over RT was seen only in younger men [≤ 60 years] with high-risk disease [p = 0.07]. The numbers needed to treat by RP instead of RT to save one cancer death was 19 for this group but 67 for the overall cohort.This study has identified significant shifts in non-metastatic prostate cancer management over the last decade. Low-risk disease is now primarily managed by CM while high-risk disease is increasingly treated radically. Treatment of high-risk younger men by RP is supported by evidence of better CSM but this benefit is not evident in older men. |
| first_indexed | 2024-04-12T10:25:49Z |
| format | Article |
| id | doaj.art-33b5a63700664a91a9882c7301706cc3 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-12T10:25:49Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-33b5a63700664a91a9882c7301706cc32022-12-22T03:36:59ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01103e011949410.1371/journal.pone.0119494Trends and outcome from radical therapy for primary non-metastatic prostate cancer in a UK population.David C GreenbergArtitaya LophatananonKaren A WrightKenneth R MuirVincent J GnanapragasamIncreasing proportions of men diagnosed with prostate cancer in the UK are presenting with non-metastatic disease. We investigated how treatment trends in this demographic have changed.Non-metastatic cancers diagnosed from 2000-2010 in the UK Anglian Cancer network stratified by age and risk group were analysed [n = 10,365]. Radiotherapy [RT] and prostatectomy [RP] cancer specific survival [CSS] were further compared [n = 4755].Over the decade we observed a fall in uptake of primary androgen deprivation therapy but a rise in conservative management [CM] and radical therapy [p<0.0001]. CM in particular has become the primary management for low-risk disease by the decade end [p<0.0001]. In high-risk disease however both RP and RT uptake increased significantly but in an age dependent manner [p<0.0001]. Principally, increased RP in younger men and increased RT in men ≥ 70y. In multivariate analysis of radically treated men both high-risk disease [HR 8.0 [2.9-22.2], p<0.0001] and use of RT [HR 1.9 [1.0-3.3], p = 0.024] were significant predictors of a poorer CSM. In age-stratified analysis however, the trend to benefit of RP over RT was seen only in younger men [≤ 60 years] with high-risk disease [p = 0.07]. The numbers needed to treat by RP instead of RT to save one cancer death was 19 for this group but 67 for the overall cohort.This study has identified significant shifts in non-metastatic prostate cancer management over the last decade. Low-risk disease is now primarily managed by CM while high-risk disease is increasingly treated radically. Treatment of high-risk younger men by RP is supported by evidence of better CSM but this benefit is not evident in older men.http://europepmc.org/articles/PMC4351083?pdf=render |
| spellingShingle | David C Greenberg Artitaya Lophatananon Karen A Wright Kenneth R Muir Vincent J Gnanapragasam Trends and outcome from radical therapy for primary non-metastatic prostate cancer in a UK population. PLoS ONE |
| title | Trends and outcome from radical therapy for primary non-metastatic prostate cancer in a UK population. |
| title_full | Trends and outcome from radical therapy for primary non-metastatic prostate cancer in a UK population. |
| title_fullStr | Trends and outcome from radical therapy for primary non-metastatic prostate cancer in a UK population. |
| title_full_unstemmed | Trends and outcome from radical therapy for primary non-metastatic prostate cancer in a UK population. |
| title_short | Trends and outcome from radical therapy for primary non-metastatic prostate cancer in a UK population. |
| title_sort | trends and outcome from radical therapy for primary non metastatic prostate cancer in a uk population |
| url | http://europepmc.org/articles/PMC4351083?pdf=render |
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