Accepted Manuscript br A year period analysis of other
A 25-year Cefepime analysis of other-cause mortality in localized prostate cancer
Sophie Knipper, Angela Pecoraro, Carlotta Palumbo, Giuseppe Rosiello, Stefano Luzzago, Zhe Tian, Alberto Briganti, Fred Saad, Derya Tilki, Markus Graefen, Pierre I. Karakiewicz
To appear in: Clinical Genitourinary Cancer
Please cite this article as: Knipper S, Pecoraro A, Palumbo C, Rosiello G, Luzzago S, Tian Z, Briganti A, Saad F, Tilki D, Graefen M, Karakiewicz PI, A 25-year period analysis of other-cause mortality
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1 A 25-year period analysis of other-cause mortality in localized prostate cancer
5 I. Karakiewicz2
7 1Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg,
9 2Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal
10 Health Center, Montreal, Quebec, Canada
11 3Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
12 4Urology Unit, ASST Spedali Civili of Brescia, Department of Medical and Surgical
13 Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
14 5Department of Urology and Division of Experimental Oncology, URI, Urological Research
15 Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
16 6European Institute of Oncology, Milan, Italy
17 7Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
19 Corresponding author: Sophie Knipper, MD
20 Martini-Klinik Prostate Cancer Center
21 University Hospital Hamburg-Eppendorf
25 Conflict of interest
26 The authors declare that they have no conflict of interest.
29 Other-cause mortality should have decreased over time in prostate cancer patients as patient
30 selection for diagnosis and treatment may have improved. We tested this hypothesis in
31 367,884 prostate cancer patients treated with radical prostatectomy or radiotherapy within the
32 Surveillance, Epidemiology and End Results database and observed important other-cause
33 mortality reduction over the last 25 years.
36 Background: We examined the changes over time in other-cause mortality (OCM) rates in
37 patients with clinically localized prostate cancer (PCa) as an indicator of patient selection.
41 multivariable Cox regression analyses assessed OCM at 5 years using stratification according
43 age group and ethnicity.
44 Results: In RP patients, OCM rates at 5 years of follow-up decreased over time from 7.9 to
46 greatest decrease in 5-year OCM rates over time was recorded in patients ≥75 years (16.0-
51 corroborated in multivariable Cox regression models.
52 Conclusions: OCM rates were highest in oldest individuals and in African-American men. In
53 both groups, an important 5-year OCM reduction over the 25-year study span was recorded.
54 Nonetheless, these two patient groups may still represent the ideal target for better patient
55 selection based on OCM considerations, since their most recent OCM rates exceeded those of
56 respectively younger and Caucasian patients.
58 Keywords: survival, radical prostatectomy, external beam radiation therapy, SEER, life