New German study below [1].
An odd observation. Perhaps the lifestyle changes that men make after diagnosis really do make a difference?
It is not surprising that the benefit would diminish with the seriousness of the cancer, but even the high-risk guys did slightly better than the life table.
"A total of 6483 patients were treated with RP between 1992 and 2007 at the Martini-Klinik Prostate Cancer Center."
"For ... low risk and intermediate risk, 10-year OS was 12.0% and 9.2% above predicted {life-expectancy} in the simulated cohort, respectively.
"... high risk, OS was virtually the same as predicted {life-expectancy}"
-Patrick
[1] pubmed.ncbi.nlm.nih.gov/341...
Prostate
. 2021 Jun 8. doi: 10.1002/pros.24176. Online ahead of print.
Long-term overall survival of radical prostatectomy patients is often superior to the general population: A comparison using life-table data
Christoph Würnschimmel 1 2 , Mike Wenzel 3 , Nuowei Wang 1 , Zhe Tian 2 , Pierre I Karakiewicz 2 , Markus Graefen 1 , Hartwig Huland 1 , Derya Tilki 1 4
Affiliations collapse
Affiliations
1 Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
2 Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.
3 Department of Urology, University Hospital Frankfurt, Frankfurt, Germany.
4 Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
PMID: 34101879 DOI: 10.1002/pros.24176
Abstract
Background: To examine overall survival rates within a large cohort of German prostate cancer (PCa) patients and to compare these with life-expectancy (LE) predictions derived from German life tables. We hypothesized that the advantage of good general health in radical prostatectomy (RP) patients combined with favorable cancer outcomes might lead to even higher overall survival rates over 10 years compared to the LE of a general population.
Methods: A total of 6483 patients were treated with RP between 1992 and 2007 at the Martini-Klinik Prostate Cancer Center. Preoperative risk classification was performed according to D'Amico. Postoperative risk classification was performed according to the Cancer of the Prostate Risk Assessment score (CAPRA-S). A simulated cohort was created that resembled the exact age distribution of the RP population using Monte Carlo simulation which was based on data derived from official male German life tables (1992-2017). Markov chain was used to represent natural age progression of the simulated cohort. Kaplan-Meier plots were created to display the differences between 10-year observed overall survival (OS) and the simulated, predicted LE.
Results: For D'Amico low risk and intermediate risk, 10-year OS was 12.0% and 9.2% above predicted LE in the simulated cohort, respectively. For D'Amico high risk, OS was virtually the same as predicted LE (0.8% difference in favor of RP treated patients). For CAPRA-S low and intermediate risk, OS was 11.8% and 9.7% above predicted LE. For CAPRA-S high risk, OS was virtually the same as predicted LE (0.3% difference in favor of the simulated cohort).
Conclusions: Low- and intermediate risk PCa patients treated with RP can expect a very favorable overall survival, that even exceeds LE predictions. High risk patients' overall survival perfectly aligns with LE predictions.
Keywords: life table; life-expectancy; prostate cancer; radical prostatectomy; survival.
© 2021 The Authors. The Prostate published by Wiley Periodicals LLC.
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