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- Title
Competing Mortality Contributes to Excess Mortality in Patients with Poor-Risk Lymph Node-Positive Prostate Cancer Treated with Radical Prostatectomy.
- Authors
Froehner, Michael; Scholz, Albrecht; Koch, Rainer; Hakenberg, Oliver W.; Baretton, Gustavo B.; Wirth, Manfred P.
- Abstract
Background: Factors predicting survival in men with lymph node-positive prostate cancer are still poorly defined. Pa-tients and Methods: 193 prostate cancer patients with his-topathologically proven lymph node involvement with a median follow-up of 7.3 years were studied. 94% of patients received immediate hormonal therapy. Kaplan-Meier curves were calculated to evaluate overall survival rates and com-pared with the log-rank test. Cumulative disease-specific and competing mortality rates were calculated by compet-ing risk analysis and compared with the Pepe-Mori test. Cox proportional hazard models were used to determine the in-dependent significance of predictors of all-cause mortality. Results: Age (70 years or older vs. younger), Gleason score (8-10 vs. 7 or lower) and the number of involved nodes (3 or more vs. 1-2) were identified as independent predictors of all-cause mortality. When patients with 0-1 of these risk fac-tors were compared with those with 2-3 risk factors, all- cause (rates after 10 years 21% vs. 71%, p < 0.0001), disease-specific (12 vs. 37%, p = 0.009) and competing mortality (9 vs. 33%, p = 0.02) differed significantly. Conclusions: Some of the excess mortality in patients with poor-risk lymph node-positive prostate cancer may be attributed to in-creased competing mortality, possibly caused by an interac-tion between comorbid diseases and hormonally treated persistent or progressive prostate cancer.
- Subjects
PROSTATE cancer treatment; CANCER-related mortality; PROSTATECTOMY; LYMPH nodes; HORMONE therapy; MEDICAL statistics
- Publication
Urologia Internationalis, 2012, Vol 89, Issue 2, p148
- ISSN
0042-1138
- Publication type
Article
- DOI
10.1159/000339279