A total of 106,958 cases of incident CaP have been registered in NPCR of Sweden between 1991-2008. NPCR captures in excess of 97% of all CaP cases in the Swedish Cancer Register. They assessed outcomes by linking personal identity number in the NPCR with the Cause of Death Register, the Patient Register, and Census to obtain date and cause of death, comorbidity, and socioeconomic status. Using period analysis they calculated cumulated 15-year risk of death from CaP-specific and competing causes. Mortality was calculated for five separate risk categories according to National Comprehensive Cancer Network Practice Guidelines in Oncology. The categories were low-risk CaP, intermediate-risk CaP, high-risk CaP, regionally metastatic N1 or PSA 50-100ng/ml CaP, and distant metastatic CaP.
They found strong increases in calculated cumulative 15-year CaP-specific mortality with increasing risk category and there was a continuous risk of CaP death throughout the follow-up period. For men between 65-75 years of age at date of diagnosis, with low risk CaP, risk of CaP death at 15 years of follow-up was 9%, cardiovascular death 18%, and for other competing causes 25%. For men in the same age group with intermediate-risk CaP, risk of CaP death was 19%, cardiovascular death 21%, and for other competing causes 25%.
They conclude that outcomes for men with CaP are strongly related to risk category and that there is a continuous risk of CaP death up to 15 years after date of diagnosis.
Presented by Pär Stattin, MD, PhD, et al. at the 26th Annual European Association of Urology (EAU) Congress - March 18 - 21, 2011 - Austria Centre Vienna, Vienna, Austria