Clinical and functional outcomes for risk-appropriate treatments for prostate cancer
Date
2024
Authors
Tiruye, T.Y.
O'Callaghan, M.
Ettridge, K.
Moretti, K.
Jay, A.
Higgs, B.
Santoro, K.
Kichenadasse, G.
Beckmann, K.
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Journal article
Citation
BJUI Compass, 2024; 5(1):109-120
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Abstract
Objectives: To describe real-world clinical and functional outcomes in an Australian cohort of men with localised prostate cancer according to treatment type and risk category.
Subjects and methods: Men diagnosed from 2008 to 2018 who were enrolled in South Australian Prostate Cancer Clinical Outcomes Collaborative registryāa multi-institutional prospective clinical registryāwere studied. The main outcome measures were overall survival, cancer-specific survival, decline in functional outcomes, biochemical recurrence and transition to active treatment following active surveillance. Multivariable adjusted models were applied to estimate outcomes.
Results: Of the 8513 eligible men, majority of men (46%) underwent radical prostatectomy (RP) followed by external beam radiation therapy with or without androgen deprivation therapy (EBRTā+/āāADT) in 22% of the cohort. Five-year overall survival was above 91%, and 5-year prostate cancer-specific survival was above 97% in the low- and intermediate-risk categories across all treatments. Five-year prostate cancer-specific survival in the active surveillance group was 100%. About 37% of men with high-risk disease treated with RP and 17% of men treated with EBRTā+/āāADT experienced biochemical recurrence within 5āyears of treatment. Of men on active surveillance, 15% of those with low risk and 20% with intermediate risk converted to active treatment within 2āyears. The decline in urinary continence and sexual function 12āmonths after treatment was greatest among men who underwent RP while the decline in bowel function was greatest for men who received EBRTā+/āāADT.
Conclusion: This contemporary real-world evidence on risk-appropriate treatment outcomes helps inform treatment decision-making for clinicians and patients.
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Copyright 2023 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)