Pd37-02 Survival Outcomes After Prostatectomy in a Healthy Population of Veterans: Comparison to the Surgical Cohort From Pivot
Year: 2016
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy IV1 Apr 2016PD37-02 SURVIVAL OUTCOMES AFTER PROSTATECTOMY IN A HEALTHY POPULATION OF VETERANS: COMPARISON TO THE SURGICAL COHORT FROM PIVOT Eric Kim, Suhong Luo, Katiuscia O'Brian, Niraj Badhiwala, Bettina Drake, Kenneth Carson, M'Liss Hudson, and Robert Grubb Eric KimEric Kim More articles by this author , Suhong LuoSuhong Luo More articles by this author , Katiuscia O'BrianKatiuscia O'Brian More articles by this author , Niraj BadhiwalaNiraj Badhiwala More articles by this author , Bettina DrakeBettina Drake More articles by this author , Kenneth CarsonKenneth Carson More articles by this author , M'Liss HudsonM'Liss Hudson More articles by this author , and Robert GrubbRobert Grubb More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1141AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent controversy regarding prostate-specific antigen (PSA) screening is based in part on the results of the Prostate Cancer Intervention versus Observation Trial (PIVOT). Although radical prostatectomy (RP) remains the gold-standard for curative treatment for localized prostate cancer (PCa), the study suggests there is no survival benefit for surgery compared to watchful waiting. We examined survival outcomes after RP for a healthy population of veterans and compared this to the RP cohort from PIVOT. METHODS We utilized a national cohort of 231,174 veterans between the ages of 40 and 70 years, free of heart disease, who at least annually visited the Veterans Healthcare Administration (VHA), who underwent PSA screening between October 2000 and September 2007. We identified 2805 veterans who were diagnosed with PCa, 966 of these veterans underwent RP. Kaplan-Meier and Cox proportional hazards analyses were performed for overall (OS) and cancer-specific survival (CSS). Comorbidity was measured by Charlson Comorbidity Index. Chi-squared test was used to compare our study cohort and PIVOT. P-values less than 0.05 were considered significant. RESULTS At a median follow-up of 93 months, 75 of the 966 (7.8%) men in our study cohort died as compared to 171 of the 364 (47.0%) men in the RP arm of PIVOT at median follow-up of 120 months (p<0.0001). In our study cohort, 12 deaths were attributable to PCa (1.2%), whereas 21 of the 364 (5.8%) men in the RP arm of PIVOT died of PCa (p<0.0001). Patients in our study cohort were more likely to have Gleason >7 PCa than in the surgery arm of PIVOT (50.0% versus 26.9%, p<0.0001). No patients in our study cohort carried a diagnosis of heart disease at study entry, while 11% of men in the surgery arm of PIVOT had a history of myocardial infarction or congestive heart failure and 9.9% had a history of peripheral vascular disease, cerebral vascular disease, or stroke. CONCLUSIONS Although with shorter median follow-up, OS and CSS were significantly higher for patients undergoing RP in our study cohort than the RP arm of PIVOT. Differences in OS between the two cohorts may be attributable to differences in baseline cardiovascular health. Additional studies are needed to determine if RP provides a survival benefit over watchful waiting in veterans with less comorbidity. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e855 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Eric Kim More articles by this author Suhong Luo More articles by this author Katiuscia O'Brian More articles by this author Niraj Badhiwala More articles by this author Bettina Drake More articles by this author Kenneth Carson More articles by this author M'Liss Hudson More articles by this author Robert Grubb More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2316945174