Re-assessment of 30-, 60- and 90-day mortality rates in non-metastatic prostate cancer patients treated either with radical prostatectomy or radiation therapy

Authors

  • Jens Hansen University of Montreal Health Center 1058, rue St-Denis, Montreal, QC, H2X 3J4, Canada
  • Giorgio Gandaglia University of Montreal Health Center 1058, rue St-Denis, Montreal, QC, H2X 3J4, Canada
  • Marco Bianchi University of Montreal Health Center 1058, rue St-Denis, Montreal, QC, H2X 3J4, Canada
  • Maxine Sun University of Montreal Health Center 1058, rue St-Denis, Montreal, QC, H2X 3J4, Canada
  • Michael Rink Department of Urology and Division of Medical Oncology, Weill Medical College of Cornell University, New York Presbyterian Hospital, 525 East 68th Street, Box 94, Starr 900, New York, NY 10065, USA
  • Zhe Tian University of Montreal Health Center 1058, rue St-Denis, Montreal, QC, H2X 3J4, Canada
  • Malek Meskawi University of Montreal Health Center 1058, rue St-Denis, Montreal, QC, H2X 3J4, Canada
  • Quoc-Dien Trinh University of Montreal Health Center 1058, rue St-Denis, Montreal, QC, H2X 3J4, Canada
  • Shahrokh F Shariat Department of Urology and Division of Medical Oncology, Weill Medical College of Cornell University, New York Presbyterian Hospital, 525 East 68th Street, Box 94, Starr 900, New York, NY 10065, USA
  • Paul Perrotte University of Montreal Health Center 1058, rue St-Denis, Montreal, QC, H2X 3J4, Canada
  • Felix K.-H Chun Department of Urology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
  • Markus Graefen Department of Urology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
  • Pierre I Karakiewicz University of Montreal Health Center 1058, rue St-Denis, Montreal, QC, H2X 3J4, Canada

DOI:

https://doi.org/10.5489/cuaj.749

Keywords:

radical prostatectomy, external-beam radiotherapy, mortality, prostate cancer

Abstract

Introduction: It is customary to consider deaths that occur within 90 days of surgery as caused by that surgery. However, such practice may overestimate the true short-term mortality rates after radical prostatectomy (RP). Indeed, treatment-unrelated events might affect short-term mortality rates. We assess RP-specific excess short-term mortality.

Methods: We performed a retrospective analysis of a population-based cohort of 59 010 patients (RP = 28 281 and external beam radiation therapy [EBRT] as reference group, n = 30 729) who were treated between 1998 and 2005 for non-metastatic prostate cancer. Using univariate and multivariate logistic regression analyses, we assessed the rates of 30-, 60- and 90-day mortality after either RP or EBRT.

Results: Within the cohort, 30-, 60- and 90-day mortality rates were 0.2, 0.5 and 0.6%, and 0.1, 0.4 and 0.6% for RP and EBRT patients, respectively. This resulted in overall 30-, 60, and 90- day mortality differences of 0.1, 0.1 and 0%, respectively. After stratification according to age and Charlson comorbidity index (CCI), the magnitude of these differences increased up to 3.2% in favour of EBRT in patients aged >75 years with CCI ≥2. In multivariable analysis, rates of 30-, 60- and 90-day mortality were 5.2-, 1.8- and 1.3-fold higher after RP than EBRT, respectively. Our study is limited by its non-randomized design.

Conclusion: Overall, absolute short-term mortality rates after RP are comparable to those of EBRT. The difference decreases over time: 90 days <60 days <30 days. Nonetheless, their magnitude is far from trivial in the elderly and sickest patients.

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Published

2014-02-12

How to Cite

Hansen, J., Gandaglia, G., Bianchi, M., Sun, M., Rink, M., Tian, Z., Meskawi, M., Trinh, Q.-D., Shariat, S. F., Perrotte, P., Chun, F. K.-H., Graefen, M., & Karakiewicz, P. I. (2014). Re-assessment of 30-, 60- and 90-day mortality rates in non-metastatic prostate cancer patients treated either with radical prostatectomy or radiation therapy. Canadian Urological Association Journal, 8(1-2), e75–80. https://doi.org/10.5489/cuaj.749

Issue

Vol. 8 No. 1-2 (2014): CUAJ February

Section

Original Research

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