Prostate cancer patients continue to have excess mortality up to 15 years after diagnosis
Husson O, van Steenbergen LN, Koldewijn EL, Poortmans PM, Coebergh JW, Janssen-Heijnen ML. BJU Int. 2013 Oct 16. doi: 10.1111/bju.12519. [Epub ahead of print]


Eindhoven Cancer Registry, Comprehensive Cancer Centre South, Eindhoven, The Netherlands; Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands.


OBJECTIVE: To estimate the population-based conditional 5-year relative survival rates for prostate cancer patients.

PATIENTS AND METHODS: All 98,672 patients diagnosed in the Netherlands with prostate cancer (clinical T stage 1-4) in 1989-2008 aged 45-89 years were selected from the Netherlands Cancer Registry and followed until 2010. Conditional 5-year relative survival was estimated for every subsequent year of survival up to 15 years after diagnosis.

RESULTS: Conditional 5-year relative survival decreased with time of survival since diagnosis. Excess mortality (conditional 5-year relative survival <95%) for patients with clinical T1 stage became only manifest 5 years after diagnosis and increased to almost 10% after 10 years. Patients with more advanced disease (cT2-cT4) exhibited an excess mortality of 6-12% at diagnosis which increased up to 15-22% after 10 years. Excess mortality occurred earlier for the older age groups. Five-year relative survival at diagnosis was <90% for all age groups of patients with cT3/cT4 and excess mortality for this group increased to over 20% for those who had already survived for 5 years since diagnosis.

CONCLUSION: Prostate cancer patients exhibited some excess mortality within 10 years after diagnosis, being earlier for more advanced stage and older age groups. Quantitative insight into conditional survival is useful for caregivers to help planning optimal cancer treatment and surveillance and to inform patients about their actual prognosis during follow-up, taking the current condition of the patient into account.