Primary Local Treatment & Non-Prostate Cancer Mortality in Non-Metastic Prostate Cancer

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A Canadian study assessed the association between surgery or radiotherapy, and non-prostate cancer and cardiovascular mortality in patients treated for non-metastatic prostate cancer, given the high competing risk of mortality in this population.

  • 5393 pairs of matched men were examined.
  • The 10-year cumulative incidence of non-prostate cancer mortality was higher among patients who underwent radiotherapy (12%) than surgery (8%; adjusted sub-distribution hazard ratio 1.57, 95%CI 1.35-1.83).
  • Patients treated with radiotherapy also had an increased risk of cardiovascular mortality (aHR 1.74, 95%CI 1.27-2.37).

Among patients carefully matched on cardiovascular risk factors, those treated with radiotherapy had an increased risk of non-prostate cancer mortality and cardiovascular disease. Due to the observational nature of the data, the potential for confounding remains. The magnitude and prevalence of potential residual confounders required to account for differences in treatment effects for prostate cancer was quantified.

"Association between Primary Local Treatment and Non-Prostate Cancer Mortality in Men with Non-Metastatic Prostate Cancer," Urology, 2 January 2018,