Initial non-curative treatment for favorable intermediate-risk prostate cancer.

OBJECTIVE

To compare the oncologic outcomes of intermediate-risk prostate cancer (FIR-PCa) patients receiving different initial treatment regimens as more FIR-PCa patients are now recommended for non-radical treatment due to the side effects of radical therapy.

METHODS

8616 FIR prostate cancer patients were retrospectively evaluated using the Surveillance, Epidemiology, and End Results (SEER) database (2010-2015) and reported prostate cancer-specific survival (PCSS) for groups defined by the initial treatment category. Statistical analysis was performed using Pearson's chi-square test, Multivariate Cox proportional hazard regression, and Kaplan-Meier method.

RESULTS

Kaplan-Meier curves of PCSS revealed that non-curative treatment provided worse disease control than curative management for FIR-PCa patients (Hazard ratio 5.9061; 95% confidence interval 3.3398-10.4446; p < 0.0001). After adjusting for age at diagnosis, race, T stage, PSA level, and Gleason score, non-curative management was significantly associated with a decrease in PCSS (Adjusted hazard ratio 3.34; 95% CI 1.97-5.67; p = 0.0027).

CONCLUSION

Pending prospective validation, our findings do not support a 'uniform' increment in current utilization practices for non-curative treatment strategies for FIR-PCa.