The study aimed to assess predictors and to identify patients at increased risk of prostate-cancer-specific mortality (CSM) after radical prostatectomy (RP).
A total of 2421 men with localized and locally advanced PCa who underwent RP in 2001-2017 were included in the study. CSM predictors were assessed using multivariate competing risk analysis. Death from other causes was considered a competing event. Cumulative CSM and other-cause mortality (OCM) were calculated in various combinations of predictors.
During the median 8 years (interquartile range 4.4-11.7) follow-up, 56 (2.3%) of registered deaths were due to PCa. Cumulative 10 years CSM and OCM was 3.6% (95% CI 2.7-4.7) and 15.9% (95% CI 14.2-17.9), respectively. The strongest predictors of CSM were Grade Group 5 (GG5) (hazard ratio (HR) 19.9, p < 0.0001), lymph node invasion (HR 3.4, p = 0.001), stage pT3b-4 (HR 3.1, p = 0.009), and age (HR 1.1, p = 0.0007). In groups created regarding age, stage, and GG, cumulative 10 years CSM ranged from 0.4-84.9%, whereas OCM varied from 0-43.2%.
CSM after RP is related to GGs, pathological stage, age, and combinations of these factors, whereas other-cause mortality is only associated with age. Created CSM and OCM plots can help clinicians identify patients with the most aggressive PCa who could benefit from more intensive or novel multimodal treatment strategies.
Cancers. 2022 Apr 18*** epublish ***
Daimantas Milonas, Tomas Ruzgas, Zilvinas Venclovas, Daniele Jonusaite, Aivaras Jonas Matijosaitis, Darius Trumbeckas, Edmundas Varpiotas, Stasys Auskalnis, Darijus Skaudickas, Ramunas Mickevicius, Kestutis Vaiciunas, Jonas Mickevicius, Mindaugas Jievaltas
Department of Urology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania., Department of Applied Mathematics, Kaunas University of Technology, 44249 Kaunas, Lithuania., Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.