Short-term outcomes after prostate cancer diagnosis and treatment in France


An article available in full on the Medscape web site provides an overview of short-term outcomes of > 43,000 men diagnosed with prostate cancer in France in 2009 and followed for 2 years based on data in the French national health insurance information system (SNIIRAM). You do need to register with Medscape to be able to read the article (but registration is free).

This article by Tuppin in et al. was initially published this year in BMC Urology, and like all articles based on data from healthcare administrative databases, it must be interpreted with a degree of caution. However, here are the basic findings reported by the authors:

  • The study encompassed all men of 40 years of age and older who were covered by the French general national health system in 2009
    • This represents some 11 million men or 73 percent of the male population of France of 40 years of age and older.
  • 43,460 men covered by the French general national health system were identifed as being newly diagnosed in France in 2009.
  • The average (mean) age of diagnosis was 70.3 years.
  • The age-standardized, 2-year, all-cause mortality rate for these men was 8.4 percent (which is twice that of all men in France aged 40 years and over).
  • The absolute or “crude”, 2-year, all-cause mortality rate for these men was 13 percent.
  • Of the 36,734 men who were still alive at 2 years after diagnosis
    • 38 percent had been treated by radical prostatectomy (and they had a 2-year mortality rate of 4 percent).
    • 35 percent had been treated by medical forms of androgen deprivation therapy (and they had a 2-year mortality rate of 9 percent).
    • 0.3 percent had been treated by subcapsular orchiectomy.
    • 29 percent had been treated by external beam radiation therapy (and they had a 2-year mortality rate of 14 percent, or 30 percent if they were treated by radiation therapy alone)
    • 2.5 percent had been treated by brachytherapy.
    • 1.6 percent had been treated by chemotherapy.
    • 20 percent had received no active treatment (and they had a 2-year mortality rate of 15 percent if they had been hospitalized for prostate cancer , or 8 percent if they only received long-term care).
    • Aboout 25 percent of patients had received more than one form of treatment.
  • Frequency of treatment-related adverse effects varied by age and by type of treatment.
  • For all men aged between 50 and 69 years of age who were treated for prtostate cancer (regardless of type of treatment),
    • 46 percent received treatment for erectile dysfunction.
    • 22 percent received treatment for urinary tract disorders.
  • For men between 50 and 69 years of age who were treated by prostatectomy alone,
    • 61 percent received treatment for erectile dysfunction (53 percent in the first year and 41 percent in the second year).
    • 24 percent received treatment for urinary tract disorders (23 percent in the first year and 9 percent in the second year).
  • For men between 50 and 69 years of age who were treated by external beam radiation therapy alone,
    • 7 percent received treatment for erectile dysfunction.
    • 14 percent received treatment for urinary tract disorders.

Predictably, the authors conclude that  there is a high 2-year, all-cause survival rate among men diagnosed with prostate cancer (regardless of all such factors as age, stage, PSA level, Gleason score, etc.) but there is also a high frequency of treatment for adverse effects induced by prostate cancer treatments and particularly for surgical treatment.

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