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J Cancer 2011; 2:76-80. doi:10.7150/jca.2.76 This volume Cite

Research Paper

Patients with Localised Prostate Cancer (T1 - T2) Show Improved Overall Long-Term Survival Compared to the Normal Population

Michael J. Mathers^1✉, Stephan Roth², Monika Klinkhammer-Schalke³, Michael Gerken³, Ferdinand Hofstaedter³, Stefan Wilm⁴, Theodor Klotz⁵

1. Urologische Gemeinschaftspraxis Remscheid in cooperation with Helios Clinic Wuppertal, Universitiy Witten/Herdecke, Germany
2. Department of Urology, Helios Clinik Wuppertal, University Witten/Herdecke, Germany
3. Tumor Center Regensburg, Germany
4. Institute of General Practice and Family Medicine, University Witten/Herdecke, Germany
5. Department of Urology, Weiden, Germany

✉ Corresponding author: Michael J. Mathers, M.D. Ph.D., Urologische Gemeinschaftspraxis Remscheid, Fastenrathstr. 1, 42853 Remscheid. Tel.: 0049-2919-291909; Fax: 0049-2191-291907; Email: irtimade

Abstract

Background: Little information is available on the long-term outcomes of patients with localised prostate cancer.

Objective: To examine the long-term survival of patients with localised prostate gland carcinoma T1 - T2, N0, M0 (UICC stage I and II) compared to the normal population.

Design: Retrospective cohort.

Setting: Regensburg, Germany.

Participants: Data on 2121 patients with histologically-confirmed, localised prostate cancer diagnosed between 1998 and 2007 were extracted from the cancer registry of the tumour centre in Regensburg, Germany.

Measurements: Overall survival rate in the patient cohort was estimated and compared to the expected survival rate of a comparable group in the general population derived from the official life-tables of Germany stratified by age, sex and calendar year.

Results: Ten years after diagnosis, patients with stage I and II localised prostate gland carcinoma had an approximately 10% increase in survival compared to the normal male population (Relative Survival = 110.7%, 95%-CI 106.6 - 114.8%).

Limitations: We did not examine the effect of cancer treatment or cancer aggressiveness on the overall survival of patients. We did not assess the incidence of subsequent non-primary cancers in our patient population or how this incidence affects the patients' follow-up care and survival.

Conclusions: Patients with stage I+II localised prostate gland carcinoma have improved survival compared with the normal male population. This finding cannot be explained solely by the administration of prostate carcinoma treatments, suggesting that men who participate in PSA screening may have better overall health behaviors and care than men who do not participate in screening. Future research should examine how treatment choice, especially an “active surveillance” approach to care, affects survival in these patients more than ten years after diagnosis.

Keywords: prostate cancer, outcomes research, health status, social gradient of prevention, PSA

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