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• W2342503198 abstract "The risk of prostate cancer-specific mortality (PCSM) following a diagnosis of prostate cancer may vary over time. Estimating conditional survival for prostate cancer patients is important for physicians to appropriately assess long-term prognosis, determine follow-up, and to provide appropriate surveillance. We sought to determine long-term conditional PCSM for patients with very high-risk features in a US-based cohort, hypothesizing that conditional PCSM would improve over time. The Surveillance, Epidemiology, and End Results (SEER) database was used to identify 82,599 patients diagnosed with stage IV (T4N0M0, N1M0, or M1) prostate cancer between 1973 and 2011. Five and ten-year grade-adjusted PCSM was evaluated for each group of patients according to the Fine & Gray model for competing risks after adjusting for tumor grade, age, income level, and marital status. Race-stratified analyses were also performed. There were 13,345 patients with T4 disease, 12,450 patients with N1 disease, and 41,022 patients with M1 disease. Median follow-up among survivors in the three groups was 123 months (range: 0-382 months), 61 months (range: 0-410 months), and 30 months (range: 0-370 months), respectively. Conditional PCSM improved in all three groups over time. Among patients with T4 disease, 5-year PCSM improved from 13.9% at diagnosis to 11.2%, 8.1%, and 6.5% conditioned on 5, 10, or 15 years of survival, respectively (p < 0.001 in all cases). In patients with N1 disease, 5-year PCSM increased within the first five years and decreased thereafter, from 18.9% at diagnosis to 21.4% (p < 0.001), 17.6% (p = 0.055), and 13.8% (p < 0.001), respectively. In patients with metastatic disease, 5-year PCSM improved from 57.2% at diagnosis to 41.1%, 28.8%, and 20.8%, respectively (p < 0.001). White race was associated with a greater increase in conditional survival compared to non-white race among those with T4 or N1 disease. PCSM at 5 years changes significantly over time in prostate cancer patients with stage T4, N1, or M1 prostate cancer. While patients with T4, N1, or M1 prostate cancer are never “cured,” their odds of survival increase substantially after they have survived for 5 or more years. Physicians who take care of patients with prostate cancer can use this data to guide follow-up decisions and to counsel newly diagnosed patients and survivors regarding their long-term prognosis" @default.
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• W2342503198 date "2015-11-01" @default.
• W2342503198 modified "2023-10-14" @default.
• W2342503198 title "Conditional Cancer-Specific Survival in Prostate Cancer Patients With Very-High-Risk Features: Implications for Long-Term Prognosis" @default.
• W2342503198 doi "https://doi.org/10.1016/j.ijrobp.2015.07.1067" @default.
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