Send Orders of Reprints at Bspsaif@emirates.net.ae Treatment and Mortality in Men with Localized Prostate Cancer: a Popu- Lation-based Study in California

Purpose: To provide patients and physicians with population-based estimates of mortality from prostate cancer or other causes depending upon the primary treatment modality, stratified by patient age, tumor stage and grade. Methods: We conducted a 10-year competing-risk analysis of 45,440 men diagnosed with clinically localized (T1 or T2) prostate cancer in California during 1995-1998. Information on patient characteristics, primary treatment and cause of death was obtained from the California Cancer Registry. Results: In this population-based cohort, the most common primary treatment was surgery (40.4%), followed by radio-therapy (29.1%), conservative management (20.8%), and androgen deprivation therapy (ADT) monotherapy (9.8%). Pros-tate cancer mortality differed significantly (p < 0.0001) across treatment groups among patients <80 years at diagnosis with moderately or poorly differentiated disease; the 10-year disease-specific mortality rates were generally highest for men treated with ADT monotherapy [ Conclusion: The cause-specific mortality estimates provided by this observational study can help patients and physicians better understand the expected long-term outcomes of localized prostate cancer given the initial treatment choice and practice patterns in the general population. INTRODUCTION Over the past two decades, widespread application of prostate specific antigen (PSA) testing has shifted the clinical landscape of prostate cancer to earlier stages of the disease [1].

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