Patients with prostate cancer continue to have excess mortality up to 15 years after diagnosis

Abstract

To estimate the population-based conditional 5-year relative survival rates for patients with prostate cancer (PCa). All 98 672 patients, aged 45-89 years, diagnosed in the Netherlands with PCa (clinical T stage 1-4) in the period 1989-2008 were selected from the Netherlands Cancer Registry and followed up until 2010. The conditional 5-year relative survival rate was estimated for every subsequent year of survival up to 15 years after diagnosis. The conditional 5-year relative survival rate decreased with survival time from diagnosis. Excess mortality (conditional 5-year relative survival rate <95%) for patients with clinical T1 stage only became manifest 5 years after diagnosis and increased to almost 10% after 10 years. Patients with more advanced disease (cT2-cT4) were found to have an excess mortality rate of 6-12% at diagnosis, which increased to 15-22% after 10 years. Excess mortality occurred earlier for the older age groups. The 5-year relative survival rate at diagnosis was <90% for all age groups of patients with cT3/cT4 disease and excess mortality for this group increased to >20% for those who had already survived for 5 years since diagnosis. Patients with PCa were found to have excess mortality within 10 years of diagnosis. Excess mortality was found at an earlier timepoint for patients with a more advanced stage and for older age groups. Quantitative insight into conditional survival is useful for caregivers to help plan optimum cancer treatment and surveillance and to inform patients about their actual prognosis during follow-up, taking the current condition of the patient into account.