Abstract

Purpose: To assess the potential survival benefit associated with receipt of definitive treatment (radical prostatectomy or radiation), compared to non-definitive treatment (hormonal therapy or chemotherapy) among men with metastatic prostate cancer. Methods: A cohort of men diagnosed with metastatic (T4/M1/N1 or T4/M1) prostate cancer from 1999 to 2013 in the Veterans Health Administration were identified and followed to December 28, 2014. All-cause and prostate cancer-specific mortality were evaluated at 10 years for the T4/M1/N1 cohort and 8 years for the T4/M1/ cohort. The association of definitive treatment (radical prostatectomy or radiation), compared to non-definitive (hormonal therapy or chemotherapy) with both all-cause and prostate cancer-specific mortality was assessed using inverse probability of treatment weighted (IPTW) multivariable survival analyses. Results: The cohort included 2919 with T4/M1/N1 disease and 1479 men with T4/M1 disease. Receipt of definitive treatment was associated with a reduced risk of 10-year all-cause (Hazard Ratio (HR): 0.61; 95% Confidence Interval (CI): 0.57–0.65) and prostate cancer-specific mortality (HR: 0.50; 95% CI: 0.46-0.55) among men diagnosed with T4/M1/N1 met–astatic disease. Definitive treatment was similarly associated with a reduced risk of all-cause (HR: 0.84; 95% CI: 0.77–0.91) and prostate cancer-specific (HR: 0.81; 95% CI: 0.73–0.90) mortality among men diagnosed with T4/M1 only metastatic disease. Conclusions: Definitive treatment may improve survival in men diagnosed with metastatic prostate cancer.

Original languageEnglish
Pages (from-to)24-31
Number of pages8
JournalAnnals of Epidemiology
Volume79
DOIs
StatePublished - Mar 2023

Keywords

  • Definitive treatment
  • Mortality
  • Prostate cancer
  • Survival
  • Veterans health administration

Fingerprint

Dive into the research topics of 'Definitive treatment and risk of death among men diagnosed with metastatic prostate cancer at the Veterans Health Administration'. Together they form a unique fingerprint.

Cite this