You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History (I)1 Apr 2013231 SURVIVAL ANALYSIS OF A WHOLE OF POPULATION STUDY FOR RADICAL PROSTATECTOMY IN THE PSA ERA Anthony Ta, Gianluca Severi, David Muller, Helen Kelsall, Jeremy Millar, Rodney Syme, John Pedersen, Graham Giles, and Damien Bolton Anthony TaAnthony Ta Melbourne, Australia More articles by this author , Gianluca SeveriGianluca Severi Melbourne, Australia More articles by this author , David MullerDavid Muller Melbourne, Australia More articles by this author , Helen KelsallHelen Kelsall Melbourne, Australia More articles by this author , Jeremy MillarJeremy Millar Melbourne, Australia More articles by this author , Rodney SymeRodney Syme Melbourne, Australia More articles by this author , John PedersenJohn Pedersen Melbourne, Australia More articles by this author , Graham GilesGraham Giles Melbourne, Australia More articles by this author , and Damien BoltonDamien Bolton Melbourne, Australia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1611AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Long-term survival outcomes following radical prostatectomy (RP) have been reported in the literature, but there is a paucity of data from population-based studies of men treated in the PSA era. We report 10-year follow-up data from a prospective whole of population series of men treated with RP in Victoria, Australia, between 1995 and 2000. METHODS All men who underwent RP for clinically localized prostate cancer between 1995 and 2000 were eligible for the study. Men were identified from a state-wide tumor registry for which there is mandatory reporting of new cancer diagnoses. Prostate-specific antigen (PSA) follow-up was obtained via record linkage to pathology laboratories. Deaths were identified via record linkage to the Victorian Register of Births, Deaths and Marriages. Follow-up ended at either date of death or January 2009. Survival estimates were calculated using Kaplan-Meier analysis. Multivariate Cox regression models were used to identify clinicopathological and sociodemographic predictors of survival. RESULTS During the study, 2154 RPs were performed in Victoria by 54 surgeons. PSA screening resulted in 65% of diagnoses; the remainder were diagnosed following presentation with lower urinary tract symptoms (LUTS). During a median follow-up 10.3 years, biochemical recurrence (BCR) was observed in 676 men (31.4%). Ten-year BCR-free survival was estimated to be 72%, 61% and 41% for low-, intermediate- and high-risk groups according to D'Amico classification. Cumulative prostate cancer-specific mortality (PCSM) and all-cause mortality (ACM) was 3.8% and 11.6%, respectively. A high proportion of deaths from prostate cancer occurred in men with organ-confined tumors of Gleason sum <6 (17%). Strong and consistent predictors of BCR and PCSM were seminal vesicle invasion and high Gleason score >8. Men from rural areas were also at significantly greater risk of PCSM (HR 1.78, 95% CI 1.09-2.90, p=0.02). Additional predictors of BCR included positive surgical margins, PSA, surgery in a public hospital and diagnosis prompted by investigation of LUTS. CONCLUSIONS The clinicopathologic predictors of PCSM in this whole of population study were consistent with previously published data from institutional-based series internationally. Compared to men living in metropolitan regions, those residing in rural areas had significantly greater risk of PCSM. Higher than expected mortality was observed in men with lower risk prostate cancer, which may increase with longer follow-up. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e95 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anthony Ta Melbourne, Australia More articles by this author Gianluca Severi Melbourne, Australia More articles by this author David Muller Melbourne, Australia More articles by this author Helen Kelsall Melbourne, Australia More articles by this author Jeremy Millar Melbourne, Australia More articles by this author Rodney Syme Melbourne, Australia More articles by this author John Pedersen Melbourne, Australia More articles by this author Graham Giles Melbourne, Australia More articles by this author Damien Bolton Melbourne, Australia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...