Comparative Cardiovascular Risks of Radical Prostatectomy and External Beam Radiation Therapy in Early-Stage Prostate Cancer: A Comprehensive Retrospective Analysis

被引:1
|
作者
Shan, Jiahao [1 ]
Liu, Ziyang [1 ]
Yu, Jin [1 ]
Zhang, Qiang [2 ]
Shi, Hongbin [2 ]
Ma, Lianghong [2 ,3 ,4 ]
机构
[1] Ningxia Med Univ, Clin Med Coll 1, Yinchuan, Peoples R China
[2] Ningxia Med Univ, Gen Hosp, Dept Urol, Yinchuan, Peoples R China
[3] Ningxia Med Univ, Inst Med Sci, Ningxia Human Sperm Bank, Gen Hosp, Yinchuan, Peoples R China
[4] Ningxia Med Univ, Key Lab Fertil Preservat & Maintenance, Minist Educ, Yinchuan, Peoples R China
关键词
Radical prostatectomy; Prostate cancer; Prognosis; Cardiac-specific mortality; Propensity score matching; UNITED-STATES; MORTALITY; STATISTICS; ASSOCIATION; DISEASE; MEN;
D O I
10.1245/s10434-024-15982-7
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background. The risk of cardiac disease mortality has recently become a focal point of concern within the medical community for patients with prostate cancer (PCa). Given that radical prostatectomy (RP) and external beam radiation therapy (EBRT) are the main treatment modalities for localized PCa, their specific impact on cardiovascular-specific mortality (CSM) remains unclear. This study explored the specific effects of RP and EBRT on CSM risk to guide clinical treatment decisions. Methods. Data from patients aged 45-74 years, who were diagnosed with T1-2N0M0 stage PCa from the SEER database (2010-2015), were used. Multivariate statistical methods, including propensity score matching (PSM), competing risk regression, COX regression analysis, and Fine-Gray testing, were applied to assess the impact of RP and EBRT on CSM risk. Results. Among 146,082 T1-2 stage PCa patients, cardiac disease emerged as the primary cause of death, surpassing PCa itself. Multifactorial COX regression and competing risk regression analyses indicated that local treatments do not increase CSM risk. Further analysis revealed a significant increase in CSM risk for patients undergoing only EBRT compared with those undergoing only RP (hazard ratio [HR] = 2.71, 95% confidence interval [CI] 1.96-3.74, P < 0.001), with subsequent PSM adjustment, further confirming a significantly reduced risk in the RP treatment group (HR 0.23, 95% CI 0.13-0.40, P < 0.001). Conclusions. T1-2 stage PCa patients face a significant risk of CSM, with RP offering a potential advantage over EBRT in reducing this risk. These findings encourage clinicians to comprehensively consider the potential impact on cardiac health when formulating treatment plans, providing crucial guidance for optimizing treatment strategies.
引用
收藏
页码:8427 / 8437
页数:11
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