Predicting Life Expectancy in Men With Clinically Localized Prostate Cancer

Abstract

Overall life expectancy can be predicted with a moderate degree of accuracy, sufficient for informing patient-clinician discussions but inadequate as the only determinant of the optimal management approach.

Prostate-specific membrane antigen expression as a predictor of prostate cancer progression

“…Even nomograms using Gleason score in combination with extent of biopsy core involvement, pretreatment serum PSA levels, and clinical stage fail to adequately identify all patients at risk of developing biochemical recurrence [18]. Thus, molecular prognostic biomarkers independently predicting the biologic behavior and outcome of prostate cancer are the focus of many studies [19].…”

Causes of Death After Radical Prostatectomy at a Large Tertiary Center

“…1,2 When determining which men are likely to benefit from definitive therapy for prostate cancer, patient life expectancy must be considered along with clinical stage, PSA and biopsy information. [3][4][5] Since men diagnosed with prostate cancer are unlikely to die of it, some groups suggested that the benefit of prostate cancer diagnosis is greatest when it leads to lifestyle changes that prevent or delay the competing causes of death. 6,7 However, in the RP population the nonprostate cancer causes of death after surgery remain unclear.…”

A Systematic Literature Review of Life Expectancy Prediction Tools for Patients with Localized Prostate Cancer

“…[5, 7, 8] Four models presented risks of other cause mortality only after a treatment was already selected. [9–12] These estimates are clearly influenced by treatment selection. For instance, in the Walz et al model, a 65-year-old patient with 3 comorbidities would have a 10-year probability of death from other causes of 80% if treated by radiotherapy but 40% by surgery.…”

“…Although they report concordance indices ranging from 0.60 – 0.84, the tools with higher discrimination, those of Walz et al [10] and Cowen et al [12], both required a treatment to be selected to obtain predictions…”