Prostate Cancer Survival and Mortality according to a 13-year retrospective cohort study in Brazil: Competing-Risk Analysis

Abstract

Objective: To analyze cancer-specific mortality (CSM) and other-cause mortality (OCM) among patients with prostate cancer that initiated treatment in the Brazilian Unified Health System (SUS), between 2002 and 2010, in Brazil. Methods: Retrospective observational study that used the National Oncological Database, which was developed by record-linkage techniques used to integrate data from SUS Information Systems, namely: Outpatient (SIA-SUS), Hospital (SIH-SUS), and Mortality (SIM-SUS). Cancer-specific and other-cause survival probabilities were estimated by the time elapsed between the date of the first treatment until the patients’ deaths or the end of the study, from 2002 until 2015. The Fine-Gray model for competing risk was used to estimate factors associated with patients’ risk of death. Results: Of the 112,856 studied patients, the average age was 70.5 years, 21% died due to prostate cancer, and 25% due to other causes. Specific survival in 160 months was 75%, and other-cause survival was 67%. For CSM, the main factors associated with patients’ risk of death were: stage IV (AHR = 2.91; 95%CI 2.73 - 3.11), systemic treatment (AHR = 2.10; 95%CI 2.00 - 2.22), and combined surgery (AHR = 2.30, 95%CI 2.18 - 2.42). As for OCM, the main factors associated with patients’ risk of death were age and comorbidities. Conclusion: The analyzed patients with prostate cancer were older and died mainly from other causes, probably due to the presence of comorbidities associated with the tumor.

How socioeconomic and clinical factors impact prostate‐cancer‐specific and other‐cause mortality in prostate cancer stratified by clinical stage: Competing‐risk analysis

“…The OCM rate maintained a downward trend from 2011 to 2016, which could be consistent with the results of Knipper et al, 11 who reported a decreased OCM rate in localized PCa patients from 1987 to 2011. Meanwhile, it is noteworthy that the OCM rate has varied markedly across different databases regardless of the time of investigation, with 25% in a Brazilian cohort (2002–2010), 33% in the Swedish Cancer Registry (1973–2008), and 37% in SEER database (1973–2008) 3,12 . These discrepancies result from not only the differences in treatment and management strategies, but also from the diverse definitions of OCM across these databases 13 .…”

Treatment Outcomes and Its Associated Factors Among Adult Patients with Selected Solid Malignancies at Kenyatta National Hospital: A Hospital-Based Prospective Cohort Study

“…On the other hand, the study in Brazil reported that only age and the presence of co-morbidity were significant risk factors. 39 Another study revealed that higher cancer prostate risk assessment scores and primary treatment with radiation were associated with an increased risk of death. 40 …”

Câncer de Próstata: análise de sobrevida e fatores prognósticos por faixa etária de diagnóstico

“…Ainda, diante de diagnósticos em idades mais avançadas, podem ser encontrados no paciente, maiores comorbidades, geralmente presentes na pessoa com maior idade (Braga et al, 2021;Schatten, 2018). Tais condições de agravos a saúde do homem, em conjunto, podem diminuir a expectativa de vida, aumentar a globalrelacionado a demais doenças -e interferir nas análises de tempo de sobrevida sobretudo daqueles acima de 70 anos.…”