Section of Urology, Department of Surgery, University of Chicago, Chicago, IL, USA.
Prostate Cancer Prostatic Dis. 2012 Mar;15(1):106-10. doi: 10.1038/pcan.2011.55. Epub 2011 Nov 15.
To evaluate cause-specific mortality following radical prostatectomy (RP) in a population cohort of US men adjusting for competing risks.
The Surveillance, Epidemiology and End Results (SEER) database was used to identify 120,392 men undergoing RP for clinically localized prostate cancer between 1988 and 2003. Cause-specific mortality data were extracted through 2006 and cumulative incidence was estimated using a competing risks approach.
The stage distribution of the cancers was 32% local, 28% regional, 40% unknown, and 80% of tumors Gleason ≤ 7. Median follow-up was 7 years. The 15-year prostate cancer-specific mortality was 5.3% and the non-prostate cancer mortality was 30.6%. Stage, grade and race had minimal impact on non-prostate cancer mortality. At 15 years following surgery, mortality due to cardiovascular diseases was 11%, other cancers 9.1%, and other causes 10.5%. Among men ≥ 65 years, 15-year cancer-specific mortality was 6% and non-prostate cancer mortality was 40.8%.
Following RP, death from cardiovascular diseases, other cancers, and other causes is far more common than death from prostate cancer. In men diagnosed with prostate cancer, significant efforts should be made to prevent, diagnose, and treat these diseases.
在调整竞争风险后，评估美国男性人群中接受根治性前列腺切除术（RP）的特定原因死亡率。
使用监测、流行病学和最终结果（SEER）数据库，确定 1988 年至 2003 年间 120392 名接受局部前列腺癌 RP 的男性患者。通过 2006 年提取特定原因死亡率数据，并使用竞争风险方法估计累积发生率。
癌症的分期分布为 32%局部、28%区域、40%未知，80%肿瘤 Gleason≤7。中位随访时间为 7 年。15 年前列腺癌特异性死亡率为 5.3%，非前列腺癌死亡率为 30.6%。分期、分级和种族对非前列腺癌死亡率的影响较小。在手术后 15 年，心血管疾病死亡率为 11%，其他癌症为 9.1%，其他原因占 10.5%。在≥65 岁的男性中，15 年癌症特异性死亡率为 6%，非前列腺癌死亡率为 40.8%。
在接受 RP 后，死于心血管疾病、其他癌症和其他原因的情况远比死于前列腺癌更为常见。在被诊断患有前列腺癌的男性中，应大力努力预防、诊断和治疗这些疾病。
