KEY TAKEAWAYS
- The study aimed to investigate the stage-specific conditional survival in patients with PC in relation to the increase in incidence post-2005, focusing on defining critical periods of mortality.
- Researchers observed stage-specific mortality variations in PC, highlighting the need for timely interventions and ongoing monitoring of novel treatments, especially for elderly patients.
Kari Hemminki and the team aimed to characterize conditional survival in prostate cancer (PC) around and after 2005 when the vast increase in incidence due to the opportunistic testing for prostate-specific antigen (PSA) culminated. They hypothesized that analyzing survival data during that period may help interpret survival trends. The study focused on stage-specific analysis using conditional survival to define the periods when deaths have commonly occurred.
Researchers performed an inclusive analysis using data obtained from the Swedish cancer registry for prostate cancer patients between 2004 and 2018. Tumor-node-metastatic stage classification at diagnosis was utilized to specify survival, focusing on 1-, 2.5-, and 5-year relative survival and conditional relative survival.
Small improvements were observed in stage- and age-related relative survival during the study period. Applying conditional relative survival showed that survival in stage T3 up to 2.5 years was better than survival between years 2.5 and 5. Survival in stage T4 was approximately equal in the first and the subsequent 2.5-year period. For M1, the first 2.5-year survival period was worse than the subsequent one. The proportion of high-risk and M1 disease in old patients (80+ years) remained very high, and their survival improved only modestly.
The study concluded that M1 metastases pose a greater risk of mortality within the first 2.5 years compared to the subsequent 2.5-5-year period, while T4 deaths remained consistent across both periods.
Additionally, mortality for T3 patients was lower in the initial 2.5-year period than between years 2.5 and 5 after diagnosis. Conditional survival analysis could provide valuable insights beyond 5 years post-diagnosis and facilitate monitoring of novel diagnostic and treatment approaches. Addressing survival challenges in elderly patients may necessitate enhanced clinical interventions.
The study was sponsored by the European Union’s Horizon 2020 research and innovation programme, The Swedish Research Council, Jane and Aatos Erkko Foundation, Sigrid Juselius Foundation, Finnish Cancer Organizations, University of Helsinki, Helsinki University Central Hospital, Novo Nordisk Foundation, Päivikki and Sakari Sohlberg Foundation, the Cooperatio Program, research area SURG, National Institute for Cancer Research—NICR, funded by the European Union—Next Generation EU and the SALVAGE project.
Source: https://pubmed.ncbi.nlm.nih.gov/38545829/
Hemminki K, Zitricky F, Sundquist K, et al. (2024). “Critical survival periods in prostate cancer in Sweden explored by conditional survival analysis.” Cancer Med. 2024 Apr;13(7):e7126. doi: 10.1002/cam4.7126. PMID: 38545829; PMCID: PMC10974700.
