Death After Prostatectomy Seldom Due to Prostate Cancer
Prostate cancer patients are much more likely to die from cardiovascular and other causes.
SAN FRANCISCO—Cumulative mortality from prostate cancer 15 years after radical prostatectomy is six times lower than death from other causes, according to study findings presented here at the Genitourinary Cancers Symposium. Among men older than 65 years at the time of surgery, cumulative 15-year mortality is 10 times lower.
The study also showed that cardiovascular diseases, non-prostate malignancies, and other causes contribute equally to non-prostate cancer mortality.
Researchers at the University of Chicago Pritzker School of Medicine led by Scott E. Eggener, MD, Assistant Professor of Surgery, analyzed data from 119,391 men in the Surveillance, Epidemiology, and End Results (SEER) registry diagnosed with prostate cancer between 1988 and 2003 and treated with radical prostatectomy.
Of these, 84,354 (71%) had organ-confined tumors and 93,744 (76%) had low- or intermediate-grade cancers. The median follow-up was 6.6 years. A total of 17,996 deaths occurred: 3,491 (19%) from prostate cancer, 5,240 (29%) from cardiovascular causes, 4,999 (27%) from malignancies other than prostate cancer, and 4,266 (25%) from other causes.
The overall cumulative mortality from prostate cancer was 0.8% and 3.9% at five and 15 years after surgery, the researchers reported. In men older than 65, the rates were 0.9% and 4.6%. The overall cumulative mortality from causes other than prostate cancer was 4.2% and 25.7% at five and 15 years, respectively; for men older than 65, the rates were 7.7% and 42.3%, respectively.
Dr. Eggener said he did not expect to find such a large difference between prostate-cancer mortality and mortality from other causes. The findings suggest that overall health should be a much bigger concern to men than the possibility of dying from prostate cancer following radical prostatectomy.
He and his colleagues concluded: “Significant effort should be directed at screening, preventing, and treating non-prostate cancer risks for mortality in these patients.”
The symposium is sponsored by the American Society of Clinical Oncology, the American Society for Radiation Oncology, and the Society of Urologic Oncology.