Mortality in prostate cancer

Arnon Krongrad, Hong Lai, Steven H. Lamm, Shenghan Lai

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: We evaluated in patients with prostate cancer whether treatment is associated with in decreased mortality and whether the association of treatment with mortality varies with calendar time. Materials and Methods: Using the 146,979 prostate cancer patients from the 1973 to 1990 public use tape of the Surveillance, Epidemiology and End Results program, we performed survival analysis and multivariate proportional hazards modeling to estimate the relative risk of disease specific and overall mortality. Results: In men with prostate cancer, advanced age, black race, high tumor stage and not having treatment were independently associated with disease specific and overall mortality. The relative risk of mortality in treated patients decreased significantly from 1973 to 1990. Conclusions: The fact that advanced age and black race are associated with disease specific mortality (even when treatment and stage are controlled) is a new observation, which suggests that tumor biology and/or response to treatment is worse in elderly and black men. Overall, the data are consistent with the hypothesis that treatment of prostate cancer is associated with lower disease specific and overall mortality rates. The decreases in relative mortality in treated patients from 1973 to 1990 indirectly support the theory that changes in patterns of care from 1973 to 1990 had a beneficial effect on mortality. This observation implies that future studies should account for calendar time when interpreting outcomes data.

Original languageEnglish (US)
Pages (from-to)1084-1091
Number of pages8
JournalJournal of Urology
Volume156
Issue number3
DOIs
StatePublished - Sep 1996
Externally publishedYes

Keywords

  • mortality
  • prostatic neoplasms
  • risk factors

ASJC Scopus subject areas

  • Urology

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