Comments on: 15-year outcomes after radical prostatectomy: a new predictive model

By: Terry Herbert

Terry Herbert — Fri, 31 Jul 2009 03:41:38 +0000

The issue of "How long have I got?" is rarely discussed in Forums or on Lists for some reason I have never been able to fathom. I recently wrote a piece which you can find on my Yananow web site to help men focus on the issues that might impact on survival. I had a positive response and a number of men said they found this useful.

By: Steve Z

Steve Z — Wed, 29 Jul 2009 20:10:27 +0000

For some context, please take a look at the abstract of Dr. Albertson's study of 20-year survival based on a competing risk analysis among men who were diagnosed with clinically localized prostate cancer and treated with observation or androgen withdrawal therapy alone, stratified by age at diagnosis and histological findings. "The prostate cancer mortality rate was 33 per 1000 person-years during the first 15 years of follow-up (95% confidence interval [CI], 28-38) and 18 per 1000 person years after 15 years of follow-up (95% CI, 10-29). The mortality rates for these 2 follow-up periods were not statistically different, after adjusting for differences in tumor histology (rate ratio, 1.1; 95% CI, 0.6-1.9). Men with low-grade prostate cancers have a minimal risk of dying from prostate cancer during 20 years of follow-up (Gleason score of 2-4, 6 deaths per 1000 person-years; 95% CI, 2-11). Men with high-grade prostate cancers have a high probability of dying from prostate cancer within 10 years of diagnosis (Gleason score of 8-10, 121 deaths per 1000 person-years; 95% CI, 90-156). Men with Gleason score of 5 or 6 tumors have an intermediate risk of prostate cancer death."

By: Chris

Chris — Tue, 28 Jul 2009 19:30:46 +0000

By the way, the Johns Hopkins 15-year data had no deaths and only 5 recurrences among 2,526 low-risk patients.

By: Chris

Chris — Tue, 28 Jul 2009 19:28:27 +0000

Kevin: I was 42 when diagnosed. I had surgery at Johns Hopkins by Partin for the exact reasons above. I am betting that in 15 years we will have another option for treatment. I read an article from Partin and he stated “prostate cancer is on thin ice and the ice is going to crack. ” I hope he is right. I have the article if you want it.

By: Sitemaster

Sitemaster — Tue, 28 Jul 2009 19:08:36 +0000

Kevin: There are 25-year data from Johns Hopkins based on Walsh’s patients going back to 1982. However, some have argued that this is a highly selected group of patients. The Johns Hopkins data would appear to be closely comparable to the data published in the current study. There is little doubt that surgery is a highly effective option for the treatment of prostate cancer — so long as you have a really good surgeon and you are not one of those patients who “gets unlucky” with long-term adverse effects. I am not aware of any good data giving outcomes to surgery for longer than 25 years.

By: Kevin

Kevin — Tue, 28 Jul 2009 16:28:32 +0000

Is there any meaningful data out there beyond fifteen years? One of the frustrations of being diagnosed at 44 is that I’d have liked to know about 20, 30, and even 40-year outcomes.

By: Larry Shick

Larry Shick — Tue, 28 Jul 2009 14:00:15 +0000

Thank you for this. Pity that they want $22 to read the article.