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Local treatment Associated with Prognosis among Men with Metastatic Prostate Cancer: A SEER-Based Study

  • Author Footnotes
    ⁎ Contributing equally
    Jiatong Zhou
    Footnotes
    ⁎ Contributing equally
    Affiliations
    Department of Urology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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  • Author Footnotes
    ⁎ Contributing equally
    Yiqun Cao
    Footnotes
    ⁎ Contributing equally
    Affiliations
    Department of Urology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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  • Author Footnotes
    ⁎ Contributing equally
    Haojie Chen
    Footnotes
    ⁎ Contributing equally
    Affiliations
    Department of Urology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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  • Author Footnotes
    ⁎ Contributing equally
    Yanyuan Wu
    Footnotes
    ⁎ Contributing equally
    Affiliations
    Department of Urology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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  • Jie Ding
    Correspondence
    Corresponding author: Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Yangpu, 200092 Shanghai, China
    Affiliations
    Department of Urology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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  • Jun Qi
    Correspondence
    Corresponding author: Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Yangpu, 200092 Shanghai, China
    Affiliations
    Department of Urology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
    Search for articles by this author
  • Author Footnotes
    ⁎ Contributing equally
Published:January 17, 2023DOI:https://doi.org/10.1016/j.clgc.2023.01.006

      Abstract

      Purpose

      In order to identify the impact of local treatment on overall survival (OS) and cancer-specific survival(CSS) in men with mPCa.

      Materials and methods

      Men with mPCa undergoing local treatment by radical prostatectomy (RP), radiotherapy (RT) including beam radiation and brachytherapy or no local treatment identified from Surveillance, Epidemiology, and End Results (SEER) database (2010–2015). To evaluate local therapy impact on OS and CSS in relation to baseline characteristics, univariate and multivariable Cox regression analysis was used to predict the prognostic value of local therapy in OS and CSS.

      Results

      A total of 902(25.8%) patients received local treatment and 2598(74.2%) patients did not receive local treatment in this study. The Kaplan-Meier curves showed that there was significant difference in OS between patients underwent local treatment and patients without local treatment (p=0.013) but not in CSS (p=0.068). While multivariate Cox regression analysis showed that local treatment may not significantly improve OS(p=0.724). In subgroup analysis, Among patients with prostate-specific antigent (PSA)<10ng/ml, local treatment could significantly improve OS and CSS (all p<0.05). Multivariate Cox regression analysis showed that local treatment could be used as an independent prognostic factor to improve OS in mPCa patients with PSA<10ng/ml (p=0.031). Another multivariate Cox regression analysis demonstrated that patients with mPCa undergoing RP had better OS and CSS (all p<0.05).

      Conclusions

      Our results showed that local salvage therapy did not seem to be an independent prognostic factor in all mPCa patients, but we found that local therapy can show a better prognosis in patients with lower PSA levels. Compared with RT, patients who had experienced RP may have better prognosis. We still need prospective research to further study the application value of local treatment in mPCa patients
      MicroAbstract
      local treatment may not effectively improve the prognosis of mPCa patients. Patients with low level PSA underwent local treatment had better OS. Compared with RT, RP could effectively improve the prognosis of mPCa patients.

      Keywords

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