Skip to main content

Advertisement

SpringerLink
Log in

Impact of initial local therapy on survival in men later receiving chemotherapy for prostate cancer: a population-based, propensity-weighted multivariable analysis

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

Prostate cancer remains a common disease that is frequently treated with multimodal therapy. The goal of this study was to assess the impact of treatment of the primary tumor on survival in men who go onto receive chemotherapy for prostate cancer.

Methods

Using surveillance, epidemiology and end results (SEER)-Medicare data from 1992 to 2009, we identified a cohort of 1614 men who received chemotherapy for prostate cancer. Primary outcomes were prostate cancer-specific mortality (PCSM) and all-cause mortality (ACM). We compared survival among men who had previously undergone radical prostatectomy (RP), radiation therapy (RT), or neither of these therapies. Propensity score adjusted Cox proportional hazard models and weighted Kaplan–Meier curves were used to assess survival.

Results

Compared to men who received no local treatment, PCSM was lower for men who received RP ± RT (HR 0.65, p < 0.01) and for those who received RT only (HR 0.79, p < 0.05). Patients receiving neither RP nor RT demonstrated higher PCSM and ACM than those receiving treatment in a weighted time-to-event analysis. Men who received RP + RT had longer mean time from diagnosis to initiation of chemotherapy (100.7 ± 47.7 months) than men with no local treatment (48.8 ± 35.0 months, p < 0.05).

Conclusion

In patients who go on to receive chemotherapy, treatment of the primary tumor for prostate cancer appears to confer a survival advantage over those who do not receive primary treatment. These data suggest continued importance for local treatment of prostate cancer, even in patients at high risk of failing local therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Han M, Partin AW, Piantadosi S, Epstein JI, Walsh PC (2001) Era specific biochemical recurrence-free survival following radical prostatectomy for clinically localized prostate cancer. J Urol 166(2):416–419

    Article  CAS  PubMed  Google Scholar 

  2. Steuber T, Budaus L, Walz J, Zorn KC, Schlomm T, Chun F et al (2011) Radical prostatectomy improves progression-free and cancer-specific survival in men with lymph node positive prostate cancer in the prostate-specific antigen era: a confirmatory study. BJU Int 107(11):1755–1761

    Article  PubMed  Google Scholar 

  3. Ghavamian R, Bergstralh EJ, Blute ML, Slezak J, Zincke H (1999) Radical retropubic prostatectomy plus orchiectomy versus orchiectomy alone for pTxN+ prostate cancer: a matched comparison. J Urol 161(4):1223–1227

    Article  CAS  PubMed  Google Scholar 

  4. Thompson IM, Tangen C, Basler J, Crawford ED (2002) Impact of previous local treatment for prostate cancer on subsequent metastatic disease. J Urol 168(3):1008–1012

    Article  PubMed  Google Scholar 

  5. Halabi S, Vogelzang NJ, Ou SS, Small EJ (2007) The impact of prior radical prostatectomy in men with metastatic castration recurrent prostate cancer: a pooled analysis of 9 cancer and leukemia group B trials. J Urol 177(2):531–534

    Article  PubMed  Google Scholar 

  6. Tannock IF, de Wit R, Berry WR, Horti J, Pluzanska A, Chi KN et al (2004) Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 351(15):1502–1512

    Article  CAS  PubMed  Google Scholar 

  7. Flanigan RC, Salmon SE, Blumenstein BA, Bearman SI, Roy V, McGrath PC et al (2001) Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer. N Engl J Med 345(23):1655–1659

    Article  CAS  PubMed  Google Scholar 

  8. Belldegrun A, Shvarts O, Figlin RA (2000) Expanding the indications for surgery and adjuvant interleukin-2-based immunotherapy in patients with advanced renal cell carcinoma. Cancer J Sci Am 6(Suppl 1):S88–S92

    PubMed  Google Scholar 

  9. Warren JL, Klabunde CN, Schrag D, Bach PB, Riley GF (2002) Overview of the SEER-medicare data: content, research applications, and generalizability to the united states elderly population. Med Care 40(8 Suppl):IV-3-18

    PubMed  Google Scholar 

  10. Potosky AL, Riley GF, Lubitz JD, Mentnech RM, Kessler LG (1993) Potential for cancer related health services research using a linked medicare-tumor registry database. Med Care 31(8):732–748

    Article  CAS  PubMed  Google Scholar 

  11. Klabunde CN, Potosky AL, Legler JM, Warren JL (2000) Development of a comorbidity index using physician claims data. J Clin Epidemiol 53(12):1258–1267

    Article  CAS  PubMed  Google Scholar 

  12. Deyo RA, Cherkin DC, Ciol MA (1992) Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 45(6):613–619

    Article  CAS  PubMed  Google Scholar 

  13. Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis 40(5):373–383

    Article  CAS  PubMed  Google Scholar 

  14. Charlson ME, Sax FL, MacKenzie CR, Braham RL, Fields SD, Douglas RG Jr (1987) Morbidity during hospitalization: Can we predict it? J Chronic Dis 40(7):705–712

    Article  CAS  PubMed  Google Scholar 

  15. Zelefsky MJ, Eastham JA, Cronin AM, Fuks Z, Zhang Z, Yamada Y et al (2010) Metastasis after radical prostatectomy or external beam radiotherapy for patients with clinically localized prostate cancer: a comparison of clinical cohorts adjusted for case mix. J Clin Oncol 28(9):1508–1513

    Article  PubMed  PubMed Central  Google Scholar 

  16. Cooperberg MR, Vickers AJ, Broering JM, Carroll PR (2010) Comparative risk-adjusted mortality outcomes after primary surgery, radiotherapy, or androgen-deprivation therapy for localized prostate cancer. Cancer 116(22):5226–5234

    Article  PubMed  PubMed Central  Google Scholar 

  17. Swanson GP, Riggs M, Earle J (2004) Failure after primary radiation or surgery for prostate cancer: differences in response to androgen ablation. J Urol 172(2):525–528

    Article  PubMed  Google Scholar 

  18. Culp SH, Schellhammer PF, Williams MB (2014) Might men diagnosed with metastatic prostate cancer benefit from definitive treatment of the primary tumor? A SEER-based study. Eur Urol 65:1058–1066

    Article  PubMed  Google Scholar 

  19. Satkunasivam R, Kim AE, Desai M, Nguyen MM, Quinn DI, Ballas L et al (2015) Radical prostatectomy or external beam radiation therapy vs no local therapy for survival benefit in metastatic prostate cancer: as SEER-Medicare analysis. J Urol 194:378–385

    Article  PubMed  PubMed Central  Google Scholar 

  20. Herr HW, Donat SM, Bajorin DF (2001) Post-chemotherapy surgery in patients with unresectable or regionally metastatic bladder cancer. J Urol 165(3):811–814

    Article  CAS  PubMed  Google Scholar 

  21. Kaplan RN, Rafii S, Lyden D (2006) Preparing the “soil”: the premetastatic niche. Cancer Res 66(23):11089–11093

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Kim MY, Oskarsson T, Acharyya S, Nguyen DX, Zhang XHF, Norton L et al (2009) Tumor self-seeding by circulating cancer cells. Cell 139:1315–1326

    Article  PubMed  PubMed Central  Google Scholar 

  23. Briganti A, Karnes JR, Da Pozzo LF, Cozzarini C, Gallina A, Suardi N et al (2009) Two positive nodes represent a significant cut-off value for cancer specific survival in patients with node positive prostate cancer. A new proposal based on a two-institution experience on 703 consecutive N+ patients treated with radical prostatectomy, extended pelvic lymph node dissection and adjuvant therapy. Eur Urol 55(2):261–270

    Article  PubMed  Google Scholar 

  24. Heidenreich A, Pfister D, Porres D (2015) Cytoreductive radical prostatectomy in patients with prostate cancer and low volume skeletal metastases: results of a feasibility and case–control study. J Urol 193:832–838

    Article  PubMed  Google Scholar 

  25. Steinberg GD, Epstein JI, Piantadosi S, Walsh PC (1990) Management of stage D1 adenocarcinoma of the prostate: the Johns Hopkins experience 1974 to 1987. J Urol 144(6):1425–1432

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the Applied Research Program, NCI; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database.

Authors’ contribution

J. Zabell was involved in project development and manuscript writing. O. Adejoro participated in project development, data management, data analysis, and manuscript editing. S. Jarosek was involved in data analysis and manuscript editing. S. P. Elliott contributed to project development and manuscript editing. B. R. Konety was involved in project development and manuscript writing/editing.

Author information

Author notes

  1. Joseph R. Zabell

    Present address: Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Ave, Q10, Cleveland, OH, 44195, USA

Authors and Affiliations

  1. Department of Urology, University of Minnesota, MMC 394 Mayo 420 Delaware St SE, Minneapolis, MN, 55455, USA

    Joseph R. Zabell, Oluwakayode Adejoro, Stephanie L. Jarosek, Sean P. Elliott & Badrinath R. Konety

Authors
  1. Joseph R. Zabell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Oluwakayode Adejoro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephanie L. Jarosek
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sean P. Elliott
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Badrinath R. Konety
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joseph R. Zabell.

Ethics declarations

The collection of this data was performed under and IRB-approved protocol. Retrospective analysis was performed using de-identified data.

Conflict of interest

The authors declare no directly relevant conflicts of interest, but all potential conflicts and associations are listed below. Authors J Zabell, O Adejoro, and S Jarosek declare no conflict of interest. Drs. Elliott and Konety have no directly relevant conflicts of interest, but do have the following financial relationships. Dr. Elliott is a consultant/advisor for AMS, GT Urological, Percuvision, Auxilium. Dr. Konety is a consultant/advisor for Photocure, Inc., Axogen, Inc., Dendreon, and has been involved in scientific trial for Dendreon, Myriad Genetics.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 135 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zabell, J.R., Adejoro, O., Jarosek, S.L. et al. Impact of initial local therapy on survival in men later receiving chemotherapy for prostate cancer: a population-based, propensity-weighted multivariable analysis. World J Urol 34, 1397–1403 (2016). https://doi.org/10.1007/s00345-016-1790-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-016-1790-x

Keywords

Search

Navigation