PD21-03 THIRTY-YEAR OUTCOMES FOR MEN WITH PROSTATE CANCER ON WATCHFUL WAITING. NATION-WIDE POPULATION-BASED STUDY

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD21-03 THIRTY-YEAR OUTCOMES FOR MEN WITH PROSTATE CANCER ON WATCHFUL WAITING. NATION-WIDE POPULATION-BASED STUDY Eugenio Ventimiglia, Christian Corsini, Pär Stattin, and Hans Garmo Eugenio VentimigliaEugenio Ventimiglia More articles by this author , Christian CorsiniChristian Corsini More articles by this author , Pär StattinPär Stattin More articles by this author , and Hans GarmoHans Garmo More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003287.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To model long-term outcomes for men with prostate cancer (PCa) on watchful waiting. METHODS: We developed and applied a state transition model based on data from 11,648 men with PCa managed with watchful waiting (WW) and registered in Prostate Cancer data Base Sweden (PCBaSe). For each man, we calculated the estimated remaining lifetime (ERL) at PCa diagnosis using a previously validated model including both Charlson Comorbidity Index (CCI) and a novel drug comorbidity index (DCI). We analysed the incidence of transition from WW to next treatment state; androgen deprivation therapy, castration resistant PCa, and death from PCa or other causes, stratified according to ERL. We then estimated the duration of time spent in the WW state and the proportion of wen who transitioned to CRPC or PCa death for each combination of PCa baseline risk category and ERL RESULTS: Median (IQR) age at diagnosis was 76 (72-81) years. A majority of men (62%) had no comorbidities (CCI=0, n=7246). Low-risk PCa was diagnosed in 3328 (28%) men, whereas higher-risk PCa (Gleason ≥3+4 or PSA>20 ng/ml or local stage T3) in 40% men. Median ERL was 10.5 years (IQR 7.9-13.5). Men in the low-risk PCa risk category managed with WW had shorter ERL (43 % below the median ERL value) vs. men with higher-risk PCa (61% below the median ERL value). Among men with ERL above median, 58% of men with low-risk PCa were still in the WW state 10 years after diagnosis vs 38% in the higher-risk PCa. At 30 years after diagnosis among men with ERL above median, the proportion of PCa death was 17% for low-risk PCa death and 23% for higher-risk PCa. CONCLUSIONS: One out of two men on watchful waiting had an ERL of at least 10 years, and ten years after diagnosis more than half of these men were still on watchful waiting. Death from other causes was the most common outcome for these men, even for men with higher-risk disease at diagnosis. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e590 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eugenio Ventimiglia More articles by this author Christian Corsini More articles by this author Pär Stattin More articles by this author Hans Garmo More articles by this author Expand All Advertisement PDF downloadLoading ...