Survival and mortality of elderly men with localized prostate cancer managed with primary androgen deprivation therapy or by primary observation Article Swipe
Heikki Seikkula
,
Peter J. Boström
,
Karri Seppä
,
Janne Pitkäniemi
,
Nea Malila
,
Antti Kaipia
·
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.21203/rs.2.13155/v3
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.21203/rs.2.13155/v3
Background: Androgen deprivation therapy (ADT) remains a primary treatment for localized prostate cancer (PCa) even though there is no evidence that its use is beneficial in the absence of curative treatment. Methods: Men aged ≥70 years ( n = 16534) diagnosed with localized PCa from 1985 to 2014 and managed either with primary observation or ADT in the absence of curative treatment were included. The cases were identified from the population-based Finnish Cancer Registry. We estimated the standardized mortality ratios (SMR) for overall mortality by treatment group. We determined the relative risk (RR) of PCa-specific mortality (PCSM) and other-cause mortality between the two treatment groups. Survival was determined using the life table method. Two age groups (70–79 years and ≥80 years) and three calendar time cohorts (1985–1994, 1995–2004, and 2005–2014) were compared following adjustment of propensity score matching between the treatment groups with four covariates (age, year of diagnosis, educational level, and hospital district). Follow-up continued until death or until December 31, 2015. Results: Patients in the observation group had lower overall SMRs than those in the ADT group in both age cohorts over the entire study period. PCSM was higher in men aged 70–79 years undergoing primary ADT compared to those managed by observation only (RR: 1.70, 95% confidence interval [CI]: 1.29–2.23 [1985–1994]; RR 1.55, 95% CI: 1.35–1.84 [1995–2004]; and RR 2.71, 95% CI: 2.08–3.53 [2005–2014]); p = 0.005 for periodic trend. A similar trend over time was also observed in men aged >80 years; ( p for age–period interaction = 0.237). Overall survival was also higher among men in their 70’s managed by observation compared to those undergoing ADT. Conclusions: Primary ADT within four months period from diagnosis is not associated with improved long-term overall survival or decreased PCSM compared to primary conservative management for men with localized PCa. However, this observational study’s conclusions should be weighted with confounding factors related to cancer aggressiveness and comorbidities.
Related Topics
Concepts
Androgen deprivation therapy
Prostate cancer
Medicine
Primary treatment
Primary (astronomy)
Primary care
Oncology
Androgen
Prostate
Internal medicine
Gerontology
Cancer
Family medicine
Hormone
Astronomy
Physics
Metadata
- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.21203/rs.2.13155/v3
- https://www.researchsquare.com/article/rs-3869/v3.pdf?c=1631845447000
- OA Status
- green
- References
- 29
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4234151389
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4234151389Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.21203/rs.2.13155/v3Digital Object Identifier
- Title
-
Survival and mortality of elderly men with localized prostate cancer managed with primary androgen deprivation therapy or by primary observationWork title
- Type
-
preprintOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2020Year of publication
- Publication date
-
2020-02-25Full publication date if available
- Authors
-
Heikki Seikkula, Peter J. Boström, Karri Seppä, Janne Pitkäniemi, Nea Malila, Antti KaipiaList of authors in order
- Landing page
-
https://doi.org/10.21203/rs.2.13155/v3Publisher landing page
- PDF URL
-
https://www.researchsquare.com/article/rs-3869/v3.pdf?c=1631845447000Direct link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
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https://www.researchsquare.com/article/rs-3869/v3.pdf?c=1631845447000Direct OA link when available
- Concepts
-
Androgen deprivation therapy, Prostate cancer, Medicine, Primary treatment, Primary (astronomy), Primary care, Oncology, Androgen, Prostate, Internal medicine, Gerontology, Cancer, Family medicine, Hormone, Astronomy, PhysicsTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
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29Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| referenced_works | https://openalex.org/W2035397440, https://openalex.org/W2094471150, https://openalex.org/W2120993630, https://openalex.org/W2031951766, https://openalex.org/W2065616395, https://openalex.org/W2045644088, https://openalex.org/W2162127733, https://openalex.org/W2165983722, https://openalex.org/W2598151303, https://openalex.org/W2106147539, https://openalex.org/W2139577967, https://openalex.org/W4395473939, https://openalex.org/W2125837480, https://openalex.org/W2163098725, https://openalex.org/W2098998490, https://openalex.org/W2140905531, https://openalex.org/W2165990809, https://openalex.org/W2105310697, https://openalex.org/W2082540132, https://openalex.org/W2513174217, https://openalex.org/W2081052928, https://openalex.org/W2106458814, https://openalex.org/W2109621894, https://openalex.org/W1982473888, https://openalex.org/W2030240052, https://openalex.org/W2249465008, https://openalex.org/W2572491672, https://openalex.org/W2103212323, https://openalex.org/W2103263363 |
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