Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Clinical Research

Cause-specific mortality following radical prostatectomy

Abstract

Background:

To evaluate cause-specific mortality following radical prostatectomy (RP) in a population cohort of US men adjusting for competing risks.

Methods:

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.

Results:

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%.

Conclusions:

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.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ . Cancer Statistics, 2009. CA Cancer J Clin 2009; 59: 225–249.

    Article  Google Scholar 

  2. Eggener SE, Scardino PT, Walsh PC, Han M, Partin AW, Trock BJ et al. Predicting 15-year prostate cancer specific mortality after radical prostatectomy. J Urol 2011; 185: 869–875.

    Article  Google Scholar 

  3. Satariano WA, Ragland KE, Van Den Eeden SK . Cause of death in men diagnosed with prostate carcinoma. Cancer 1998; 83: 1180–1188.

    Article  CAS  Google Scholar 

  4. Newschaffer CJ, Otani K, McDonald MK, Penberthy LT . Causes of death in elderly prostate cancer patients and in a comparison nonprostate cancer cohort. J Nat Cancer Inst 2000; 92: 613–621.

    Article  CAS  Google Scholar 

  5. Cancer Statistics Datasets & Software Publications Information for Cancer Registrars, Homepage. http://www.seer.cancer.gov/.

  6. Surveillance Research Program, NCI. Cancer Statistics Datasets & Software Publications Information for Cancer Registrars. http://www.seer.cancer.gov/codrecode/1969+_d09172004/index.html.

  7. Surveillance Research Program, NCI. SEER Program: Camparative Staging Guide for Cancer. http://www.seer.cancer.gov/manuals/historic/comp_stage1.1pdf.

  8. Gooley TA, Leisenring W, Crowley J, Storer BE . Estimation of failure probabilities in the presence of competing risks: new representations of old estimators. Stat Med 1999; 18: 695–706.

    Article  CAS  Google Scholar 

  9. Kim HT . Cumulative incidence in competing risks data and competing risks regression analysis. Clin Cancer Res 2007; 13: 559–565.

    Article  Google Scholar 

  10. Marubini E, M GV . Analysing Survival Data from Clinical Trials and Observational Studies. Wiley: Chichester, 1995.

    Google Scholar 

  11. Blanchard CM, Courneya KS, Stein K . Cancer survivors′ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society′s SCS-II. J Clin Onc 2008; 26: 2198–2204.

    Article  Google Scholar 

  12. Stattin P, Holmberg E, Johansson JE, Holmberg L, Adolfsson J, Hugosson J et al. Outcomes in localized prostate cancer: National Prostate Cancer Register of Sweden Follow-up Study. J Nat Cancer Inst 2010; 102: 950–958.

    Article  Google Scholar 

  13. Albertsen PC, Hanley JA, Penson DF, Barrows G, Fine J . 13-year outcomes following treatment for clinically localized prostate cancer in a population based cohort. J Urol 2007; 177: 932–936.

    Article  Google Scholar 

  14. Dignam JJ, Kocherginsky MN . Choice and interpretation of statistical tests used when competing risks are present. J Clin Onc 2008; 26: 4027–4034.

    Article  Google Scholar 

  15. Abdollah F, Sun M, Thuret R, Jeldres C, Tian Z, Briganti A et al. A competing-risks analysis of survival after alternative treatment modalities for prostate cancer patients: 1988–2006. Eur Urol 2011; 59: 88–95.

    Article  Google Scholar 

  16. Bill-Axelson A, Holmberg L, Filen F, Ruutu M, Garmo H, Busch C, Nordling S et al. Radical prostatectomy versus watchful waiting in localized prostate cancer: the Scandinavian Prostate Cancer Group-4 randomized trial. J Nat Cancer Inst 2008; 100: 1144–1154.

    Article  Google Scholar 

  17. Keating NL, O’Malley AJ, Smith MR . Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer. J Clin Onc 2006; 24: 4448–4456.

    Article  CAS  Google Scholar 

  18. Saigal CS, Gore JL, Krupski TL, Hanley J, Schonlau M, Litwin MS et al. Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer. Cancer 2007; 110: 1493–1500.

    Article  CAS  Google Scholar 

  19. Penson DF, Albertsen PC, Nelson PS, Barry M, Stanford JL . Determining cause of death in prostate cancer: Are death certificates valid? J Nat Cancer Inst 2001; 93: 1822–1823.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S Shikanov.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Appendix A

Appendix A

SEER codes used for cause of death definition

Prostate cancer: 28010

Cardiovascular diseases: 50060, 50070, 50080, 50090, 50100, 50110

Other cancers: 20010, 20020, 20030, 20040, 20050, 20060, 20070, 20080, 20090, 20100, 21010, 21020, 21030, 21040, 21050, 21060, 21071, 21072, 21080, 21090, 21100, 2110, 21120, 21130, 22010, 22020, 22030, 22040, 22050, 22060, 23000, 24000, 25010, 25020, 26000, 27010, 27020, 27030, 27040, 27050, 27060, 27070, 28020, 28030, 28040, 29010, 29020, 29030, 29040, 30000, 31010, 32010, 32020, 33010, 33040, 34000, 35011, 35012, 35013, 35021, 35031, 35022, 35023, 35041, 35043, 36010, 36020, 37000

Other causes: 38000, 50000, 50010, 50030, 50040, 50050, 50051, 50120, 50130, 50140, 50150, 50160, 50170, 50180, 50190, 50200, 50210, 50220, 50230, 50300

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shikanov, S., Kocherginsky, M., Shalhav, A. et al. Cause-specific mortality following radical prostatectomy. Prostate Cancer Prostatic Dis 15, 106–110 (2012). https://doi.org/10.1038/pcan.2011.55

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/pcan.2011.55

Keywords

This article is cited by

Search

Quick links