Salvage Radical Prostatectomy: Baseline Prostate Cancer Characteristics and Survival Across SEER Registries.

Abstract

OBJECTIVE:

To test for baseline prostate cancer characteristics and survival differences after salvage radical prostatectomy (SRP) across 18 Surveillance, Epidemiology and End Results (SEER) registries from 2004 to 2016.

METHODS:

We tabulated prostate-specific antigen (PSA), cT stage, age, and SRP rates across individual SEER registries. Kaplan-Meier and competing risks regression methodologies depicted cancer-specific mortality and other cause mortality. Finally, overall mortality was compared with predicted life expectancy.

RESULTS:

Overall, 428 SRP patients (2004-2016) were identified in the SEER database. Median follow-up duration was 74 months (interquartile range [IQR], 31-114). The median age at diagnosis was 68 years (IQR, 61-73 years) with a median PSA at diagnosis of 8.8 ng/mL (IQR, 5.4-18.6 ng/mL) and 10% cT3-4 stage (0%-23.8%). Variability existed across individual SEER registries regarding age, PSA, cT stage, and annual number of SRPs (0-17), as well as cumulative numbers of SRPs (7-73) between 2004 and 2016. At 10 years, cancer-specific mortality was 23.2% vs. other cause mortality 19.3%. Finally, SRP patients exhibited higher 10-year overall mortality (43.3%) than predicted by life tables (31.8%).

CONCLUSION:

SRP is rarely performed. In most SEER registries, SRP use is very occasional. More than 2 average annual SRPs were reported in only 5 of all registries. Nonetheless, across all registries, SRP patients showed marginal to moderate differences in PSA, cT stage, and age at diagnosis. However, at 10 years of follow-up, 1 of 5 SRP patients died of other causes and observed overall mortality was higher than expected (36%).

• Authors: Mike Wenzel, Christoph Würnschimmel, Luigi Nocera, Claudia Collà Ruvolo, Zhe Tian, Shahrokh F Shariat, Fred Saad, Alberto Briganti, Markus Graefen, Andreas Becker, Luis A Kluth, Philipp Mandel, Felix K H Chun, Pierre I Karakiewicz
• Journal: Clinical genitourinary cancer (Clin Genitourin Cancer) Vol. 19 Issue 4 Pg. e255-e263 (08 2021) ISSN: 1938-0682 [Electronic] United States
• PMID: 33849813 (Publication Type: Journal Article)
• Copyright: Copyright © 2021. Published by Elsevier Inc.

Chemical References

• Prostate-Specific Antigen

Topics

• Humans
• Male
• Prostate-Specific Antigen
• Prostatectomy
• Prostatic Neoplasms (surgery)
• Registries
• Salvage Therapy