Survival After Conservative Management Versus External Beam Radiation Therapy in Elderly Patients With Localized Prostate Cancer

Paolo Dell'Oglio, Katharina Boehm, Vincent Trudeau, Zhe Tian, Alessandro Larcher, Sami-Ramzi Leyh-Bannurah, Marco Moschini, Umberto Capitanio, Shahrokh F. Shariat, Alberto Briganti, Francesco Montorsi, Fred Saad, Pierre I. Karakiewicz

Research output: Contribution to journalArticle

Abstract

Purpose To compare survival in elderly men with clinically localized prostate cancer (PCa) according to treatment type, defined as radiation therapy (RT) with or without androgen deprivation therapy (ADT) versus conservative management (observation). Methods and Materials In the Surveillance, Epidemiology, and End Results (SEER)–Medicare linked database, we identified 23,790 patients aged 80 years or more with clinically localized PCa treated with either RT or observation between 1991 and 2009. Competing risks analyses focused on cancer-specific mortality and other-cause mortality, after accounting for confounders. All analyses were repeated after stratification according to grade (well-differentiated vs moderately differentiated vs poorly differentiated disease), race, and United States region, in patients with no comorbidities and in patients with at least 1 comorbidity. Analyses were repeated within most contemporary patients, namely those treated between 2001 and 2009. Results Radiation therapy was associated with more favorable cancer-specific mortality rates than observation in patients with moderately differentiated disease (hazard ratio [HR] 0.79; 95% confidence interval [CI] 0.66-0.94; P=.009) and in patients with poorly differentiated disease (HR 0.58; 95% CI 0.49-0.69; P
Original languageEnglish
Pages (from-to)1037 - 1045
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume96
Issue number5
DOIs
Publication statusPublished - Dec 1 2016

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radiation therapy
Prostatic Neoplasms
Radiotherapy
cancer
Survival
mortality
Observation
hazards
Mortality
Comorbidity
confidence
Confidence Intervals
epidemiology
deprivation
intervals
surveillance
Medicare
stratification
Androgens
Conservative Treatment

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Survival After Conservative Management Versus External Beam Radiation Therapy in Elderly Patients With Localized Prostate Cancer. / Dell'Oglio, Paolo; Boehm, Katharina; Trudeau, Vincent; Tian, Zhe; Larcher, Alessandro; Leyh-Bannurah, Sami-Ramzi; Moschini, Marco; Capitanio, Umberto; Shariat, Shahrokh F.; Briganti, Alberto; Montorsi, Francesco; Saad, Fred; Karakiewicz, Pierre I.

In: International Journal of Radiation Oncology Biology Physics, Vol. 96, No. 5, 01.12.2016, p. 1037 - 1045.

Research output: Contribution to journalArticle

Dell'Oglio, Paolo ; Boehm, Katharina ; Trudeau, Vincent ; Tian, Zhe ; Larcher, Alessandro ; Leyh-Bannurah, Sami-Ramzi ; Moschini, Marco ; Capitanio, Umberto ; Shariat, Shahrokh F. ; Briganti, Alberto ; Montorsi, Francesco ; Saad, Fred ; Karakiewicz, Pierre I. / Survival After Conservative Management Versus External Beam Radiation Therapy in Elderly Patients With Localized Prostate Cancer. In: International Journal of Radiation Oncology Biology Physics. 2016 ; Vol. 96, No. 5. pp. 1037 - 1045.
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