Effects of Radiotherapy or Radical Prostatectomy on the Risk of Long-Term Heart-Specific Death in Patients With Prostate Cancer

Objective: The prognosis of patients with prostate cancer (PCa) has improved in recent years, but treatment-related cardiotoxicity remains unclear. This study investigated the heart-specific mortality and prognostic factors of patients with PCa after radiotherapy (RT) or radical prostatectomy (RP),...

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Main Authors: Yadong Guo, Xiaohui Dong, Fuhan Yang, Yang Yu, Ruiliang Wang, Aimaitiaji Kadier, Wentao Zhang, Shiyu Mao, Aihong Zhang, Xudong Yao
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-11-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2020.592746/full
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author Yadong Guo
Xiaohui Dong
Fuhan Yang
Yang Yu
Ruiliang Wang
Aimaitiaji Kadier
Wentao Zhang
Shiyu Mao
Aihong Zhang
Aihong Zhang
Xudong Yao
author_facet Yadong Guo
Xiaohui Dong
Fuhan Yang
Yang Yu
Ruiliang Wang
Aimaitiaji Kadier
Wentao Zhang
Shiyu Mao
Aihong Zhang
Aihong Zhang
Xudong Yao
author_sort Yadong Guo
collection DOAJ
description Objective: The prognosis of patients with prostate cancer (PCa) has improved in recent years, but treatment-related cardiotoxicity remains unclear. This study investigated the heart-specific mortality and prognostic factors of patients with PCa after radiotherapy (RT) or radical prostatectomy (RP), and compared their long-term heart-specific mortality with that of the general male population.Materials and Methods: Data were taken from the Surveillance, Epidemiology, and End Result (SEER) database. Patients with PCa were included who underwent RT or RP from 2000 to 2012, and were followed through 2015. A cumulative mortality curve and a competitive risk regression model were applied to assess the prognostic factors of heart-specific mortality. Standardized mortality rates (SMRs) were calculated.Results: Of 389,962 men, 49.7% and 50.3% received RP and RT, respectively. The median follow-up was 8.3 years. For patients given RT, in about 9 years postdiagnosis, the cumulative mortality due to heart-specific disease exceeded that due to PCa. In patients who underwent RP, cumulative mortality from heart-specific disease or PCa was comparable. Relative to the general male population, overall, the heart-specific mortality of patients with PCa receiving RT or RP was not higher, but in patients aged 70 to 79 years, those given RT experienced slightly higher heart-specific mortality than the age-matched general population.Conclusions: Patients with PCa treated with RT or RP overall do not incur risk of heart-specific mortality higher than that of the general male population, except for patients aged 70–74 years receiving RT.
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spelling doaj.art-8a4614f071c34c219f8d297aa39b39382022-12-21T23:11:23ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-11-011010.3389/fonc.2020.592746592746Effects of Radiotherapy or Radical Prostatectomy on the Risk of Long-Term Heart-Specific Death in Patients With Prostate CancerYadong Guo0Xiaohui Dong1Fuhan Yang2Yang Yu3Ruiliang Wang4Aimaitiaji Kadier5Wentao Zhang6Shiyu Mao7Aihong Zhang8Aihong Zhang9Xudong Yao10Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, ChinaDepartment of Geriatrics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, ChinaDepartment of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, ChinaDepartment of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, ChinaDepartment of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, ChinaDepartment of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, ChinaDepartment of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, ChinaDepartment of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, ChinaDepartment of Medical Statistics, Tongji University School of Medicine, Shanghai, ChinaDepartment of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, ChinaObjective: The prognosis of patients with prostate cancer (PCa) has improved in recent years, but treatment-related cardiotoxicity remains unclear. This study investigated the heart-specific mortality and prognostic factors of patients with PCa after radiotherapy (RT) or radical prostatectomy (RP), and compared their long-term heart-specific mortality with that of the general male population.Materials and Methods: Data were taken from the Surveillance, Epidemiology, and End Result (SEER) database. Patients with PCa were included who underwent RT or RP from 2000 to 2012, and were followed through 2015. A cumulative mortality curve and a competitive risk regression model were applied to assess the prognostic factors of heart-specific mortality. Standardized mortality rates (SMRs) were calculated.Results: Of 389,962 men, 49.7% and 50.3% received RP and RT, respectively. The median follow-up was 8.3 years. For patients given RT, in about 9 years postdiagnosis, the cumulative mortality due to heart-specific disease exceeded that due to PCa. In patients who underwent RP, cumulative mortality from heart-specific disease or PCa was comparable. Relative to the general male population, overall, the heart-specific mortality of patients with PCa receiving RT or RP was not higher, but in patients aged 70 to 79 years, those given RT experienced slightly higher heart-specific mortality than the age-matched general population.Conclusions: Patients with PCa treated with RT or RP overall do not incur risk of heart-specific mortality higher than that of the general male population, except for patients aged 70–74 years receiving RT.https://www.frontiersin.org/articles/10.3389/fonc.2020.592746/fullprostate cancerradiotherapyradical prostatectomycardiovascular diseasecompeting riskSEER
spellingShingle Yadong Guo
Xiaohui Dong
Fuhan Yang
Yang Yu
Ruiliang Wang
Aimaitiaji Kadier
Wentao Zhang
Shiyu Mao
Aihong Zhang
Aihong Zhang
Xudong Yao
Effects of Radiotherapy or Radical Prostatectomy on the Risk of Long-Term Heart-Specific Death in Patients With Prostate Cancer
Frontiers in Oncology
prostate cancer
radiotherapy
radical prostatectomy
cardiovascular disease
competing risk
SEER
title Effects of Radiotherapy or Radical Prostatectomy on the Risk of Long-Term Heart-Specific Death in Patients With Prostate Cancer
title_full Effects of Radiotherapy or Radical Prostatectomy on the Risk of Long-Term Heart-Specific Death in Patients With Prostate Cancer
title_fullStr Effects of Radiotherapy or Radical Prostatectomy on the Risk of Long-Term Heart-Specific Death in Patients With Prostate Cancer
title_full_unstemmed Effects of Radiotherapy or Radical Prostatectomy on the Risk of Long-Term Heart-Specific Death in Patients With Prostate Cancer
title_short Effects of Radiotherapy or Radical Prostatectomy on the Risk of Long-Term Heart-Specific Death in Patients With Prostate Cancer
title_sort effects of radiotherapy or radical prostatectomy on the risk of long term heart specific death in patients with prostate cancer
topic prostate cancer
radiotherapy
radical prostatectomy
cardiovascular disease
competing risk
SEER
url https://www.frontiersin.org/articles/10.3389/fonc.2020.592746/full
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