TY - JOUR
T1 - Is radiotherapy after radical prostatectomy associated with higher other-cause mortality?
AU - Özman, Oktay
AU - Droghetti, Matteo
AU - Pos, Floris
AU - van Leeuwen, Pim J.
AU - van der Poel, Henk
N1 - Funding Information: This study was supported by the Scientific and Technological Research Council of Turkey (TUBITAK) 2219 Grant Program. Oktay Özman has received funding from the grant. Publisher Copyright: © 2023, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
PY - 2023/12
Y1 - 2023/12
N2 - Purpose: The aim of this study was to reveal the association between the other-cause mortality (OCM) and post-radical prostatectomy (RP) salvage radiotherapy (sRT) in men with prostate cancer (PCa). Methods: A retrospective study was carried out with patients who had PCa and underwent RP ± sRT in a high-volume cancer center between 2005 and February 2019. Data from 1955 patients were subjected to a 1:1 matching for age, initial PSA, pathological (p)T/N stages, and ISUP score, which yielding 439 RP + RT (group 1) vs 439 RP-only cases (group 2), without any residual difference. Primary and secondary endpoints of the study were OCM and cancer-specific mortality (CSM). Kaplan–Meier, log-rank, and cox regression tests were used for purpose of the study. Results: The median follow-up time after RP was 5.3 years (interquartile range: 4.0–7.3). After matching, of all deaths that occurred during the study period, 16 in group 1 and 35 in group 2 were attributed to other causes (p = 0.006). 5-year OCM rate of patients who received sRT (1.2%) was significantly lower compared to patients that underwent RP-only (4.4%, p < 0.001). 19 versus 16 patients died of PCa, respectively (p = 0.61). There was no CSM risk difference between groups (p = 0.29). Older patients had an increased risk of OCM (hazard ratio [HR]:1.10 [95%CI 1.05–1.17], p < 0.001) and post-RP RT was associated with lower OCM (HR: 0.28 [95%CI 0.15–0.51], p < 0.001) in multivariable model. pT/N stages and ISUP score were strongly associated with CSM, but not with OCM. Conclusion: OCM was not higher in patients who had sRT with or without ADT. Excess OCM in favor of RP-only patients may be cautiously explained with higher-performance status/life expectancy of patients who selected for RT after RP in our cohort.
AB - Purpose: The aim of this study was to reveal the association between the other-cause mortality (OCM) and post-radical prostatectomy (RP) salvage radiotherapy (sRT) in men with prostate cancer (PCa). Methods: A retrospective study was carried out with patients who had PCa and underwent RP ± sRT in a high-volume cancer center between 2005 and February 2019. Data from 1955 patients were subjected to a 1:1 matching for age, initial PSA, pathological (p)T/N stages, and ISUP score, which yielding 439 RP + RT (group 1) vs 439 RP-only cases (group 2), without any residual difference. Primary and secondary endpoints of the study were OCM and cancer-specific mortality (CSM). Kaplan–Meier, log-rank, and cox regression tests were used for purpose of the study. Results: The median follow-up time after RP was 5.3 years (interquartile range: 4.0–7.3). After matching, of all deaths that occurred during the study period, 16 in group 1 and 35 in group 2 were attributed to other causes (p = 0.006). 5-year OCM rate of patients who received sRT (1.2%) was significantly lower compared to patients that underwent RP-only (4.4%, p < 0.001). 19 versus 16 patients died of PCa, respectively (p = 0.61). There was no CSM risk difference between groups (p = 0.29). Older patients had an increased risk of OCM (hazard ratio [HR]:1.10 [95%CI 1.05–1.17], p < 0.001) and post-RP RT was associated with lower OCM (HR: 0.28 [95%CI 0.15–0.51], p < 0.001) in multivariable model. pT/N stages and ISUP score were strongly associated with CSM, but not with OCM. Conclusion: OCM was not higher in patients who had sRT with or without ADT. Excess OCM in favor of RP-only patients may be cautiously explained with higher-performance status/life expectancy of patients who selected for RT after RP in our cohort.
KW - Other-cause mortality
KW - Prostate cancer
KW - Radical prostatectomy
KW - Salvage radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=85166243907&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s10552-023-01767-y
DO - https://doi.org/10.1007/s10552-023-01767-y
M3 - Article
C2 - 37522983
SN - 0957-5243
VL - 34
SP - 1139
EP - 1144
JO - Cancer Causes and Control
JF - Cancer Causes and Control
IS - 12
ER -