PCN25 Effect of Treatments for Late-Stage Prostate Cancer on Survival

Abstract

This study examined the relative effectiveness of treatments increasing the survival time for late-stage prostate cancer. Cox proportional hazard regression model was used to assess overall survival in relation to various treatments adjusting for confounding factors. Survival time was calculated from the date of initial diagnosis to the last day of contact. Patient demographics, type of health insurance stage, and grade of the tumor were extracted from Florida Cancer Data System. Socioeconomic factors were extracted from Census 2000. The types of co-morbidity were formulated following the Elixhauser Index. The Census 2000 and Florida Agency for Health Care and Administration datasets were linked with the Florida Cancer Data system for the time between October 1, 2001 and December 31, 2007 with survival being measured through October 31, 2008. A total of 4336 men who had late-stage prostate cancer in Florida were analyzed. The average age at the time of diagnosis was 65 and the average survival time was 253 days. Among patients who had late-stage prostate cancer, 59 percent received surgical treatment only. The log-rank and Wilcoxon tests indicated that there were significant differences in survival time by treatment options. The cox proportional hazard regression result showed that patients who had received radiation only, hormone only, and those who had chosen active surveillance were at a higher risk of having shorter survival time than those who had received surgery only. The existence of one or more co-morbidity, being diagnosed at an older age, and being uninsured were associated with higher mortality. The study found that men who received the following treatments received radiation only, hormone only, chose active surveillance, with co-morbidity and of advanced age had lower survival benefit. Further, research that is foucsed on the specific cause of death may help understand the impacts of treatment and covariates on prostate cancer survival.