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Natural history, and impact of surgery and radiation on survival outcomes of men diagnosed with low-grade prostate cancer at ≤ 55 years of age: a 25-year follow-up of > 60,000 men

  • Urology - Original Paper
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Abstract

Purpose

Low-grade prostate cancer has low mortality rates at 10 years; however, it is unclear if the response is sustained for up to 25 years of follow-up.

Methods

Using Surveillance, Epidemiology, and End Results database, the overall and cancer-specific mortality rates were compared among men ≤ 55 years of age diagnosed with low-grade prostate cancer that either had radical prostatectomy, radiotherapy, or no known treatment.

Results

Of the 62,772 men diagnosed with low-grade prostate cancer between 1975 and 2016, about 60%, 20% and 20% of men underwent radical prostatectomy, radiotherapy, and no known treatment, respectively. At a median follow-up of 10 years, almost 2% and 7% of men died of prostate cancer and other causes, respectively. The overall mortality was significantly better in radical prostatectomy group compared to no known treatment group (HR 1.99, CI 1.84–2.15, P value < 0.001), but not between the radiotherapy and no known treatment groups. Moreover, the overall and cancer-specific mortality rates in the radiotherapy group were almost two and three times compared to the radical prostatectomy group, respectively (HR 2.15, CI 2.01–2.29, P value < 0.001 for overall mortality and HR 2.87, CI 2.5–3.29, P value < 0.001 for cancer-specific mortality).

Conclusions

The study confirms low mortality rates in men diagnosed with low-grade prostate cancer for over 25 years’ follow-up. While radical prostatectomy improves survival significantly compared to no known treatment, radiotherapy is associated with an increase in overall and cancer-specific mortality, which may be related to long-term toxicities.

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Authors and Affiliations

  1. Department of Urology, University of Florida, 655 8th St W, Jacksonville, FL, 32209, USA

    Seyed Behzad Jazayeri, Soroush Bazargani, Devon Thomas, Joseph Costa, Mark Bandyk, Hariharan Palayapalayam Ganapathi, Shahriar Koochekpour & K. C. Balaji

  2. Department of Biostatistics, University of Florida, Jacksonville, FL, USA

    Daniel Norez, Jennifer Woolfe & Shiva Gautam

  3. Department of Urology, Armstrong County Memorial Hospital, Kittanning, PA, 16201, USA

    Muhammad Umar Alam & Jatinder Kumar

  4. Department of Urology, Medical University of South Carolina, Florence, South Carolina, USA

    Karthik Tanneru

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  1. Muhammad Umar Alam
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  2. Jatinder Kumar
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  3. Daniel Norez
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  4. Jennifer Woolfe
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  14. K. C. Balaji
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Correspondence to Muhammad Umar Alam.

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Alam, M.U., Kumar, J., Norez, D. et al. Natural history, and impact of surgery and radiation on survival outcomes of men diagnosed with low-grade prostate cancer at ≤ 55 years of age: a 25-year follow-up of > 60,000 men. Int Urol Nephrol 55, 295–300 (2023). https://doi.org/10.1007/s11255-022-03363-6

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  • DOI: https://doi.org/10.1007/s11255-022-03363-6

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