1. Association between Radical Prostatectomy and Survival in Men with Clinically Node-positive Prostate Cancer
- Author
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Sarkar, Reith R, Bryant, Alex K, Parsons, J Kellogg, Ryan, Stephen T, Kader, A Karim, Kane, Christopher J, McKay, Rana R, Sandhu, Ajay, Murphy, James D, and Rose, Brent S
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Oncology and Carcinogenesis ,Cancer ,Aging ,Prostate Cancer ,Clinical Trials and Supportive Activities ,Urologic Diseases ,Clinical Research ,Patient Safety ,Evaluation of treatments and therapeutic interventions ,6.4 Surgery ,Good Health and Well Being ,Aged ,Androgen Antagonists ,Chemoradiotherapy ,Chemotherapy ,Adjuvant ,Humans ,Lymph Node Excision ,Lymph Nodes ,Lymphatic Metastasis ,Male ,Middle Aged ,Neoadjuvant Therapy ,Neoplasm Grading ,Prostate ,Prostatectomy ,Prostatic Neoplasms ,Survival Analysis ,Time Factors ,Treatment Outcome ,Clinically node-positive ,Multimodal therapy ,Prostate cancer ,prostate cancer-specific mortality ,Radical prostatectomy ,prostate cancer–specific mortality ,Clinical sciences ,Oncology and carcinogenesis - Abstract
Evidence supporting radical prostatectomy (RP) for men with clinically node-positive (cN+) prostate cancer (PC) is limited. In a US national database, we identified 741 men with cN+ nonmetastatic PC diagnosed during 2000-2015 who underwent definitive local therapy with RP (n=78), radiotherapy (RT) with neoadjuvant androgen deprivation therapy (ADT) (n=193), or nondefinitive therapy with ADT alone (n=445) or observation (n=25). We compared PC-specific mortality (PCSM) and all-cause mortality (ACM) using multivariable Fine-Gray competing risk regression and Cox regression, respectively. Compared to nondefinitive therapy, RP was associated with significantly better PCSM (subdistribution hazard ratio [SHR] 0.32, 95% confidence interval [CI] 0.16-0.66; p=0.002) and ACM (HR 0.36, 95% CI 0.21-0.61; p
- Published
- 2019