Androgen-deprivation therapy versus radical prostatectomy as monotherapy among clinically localized prostate cancer patients

Figures & data

Table 1 Baseline information between the PADT and RP cohorts before propensity score-matching

	PADT		RP		P
	n	%	n	%
	5804	100	5182	100
Race					<0.0001
Not white	1357	23.38	741	14.30
White	4447	76.62	4441	85.70
Married					<0.0001
No	2064	35.56	896	17.29
Yes	3740	64.44	4286	82.71
Urban residence					<0.0001
No	708	12.20	480	9.26
Yes	5096	87.80	4702	90.74
PSA					<0.0001
Low	583	10.04	116	2.24
Median	2447	42.16	2378	45.89
High	1003	17.28	791	15.26
Positive	48	0.83	151	2.91
Unknown	973	16.76	1423	27.46
T-score					<0.0001
T1	3318	57.17	768	14.82
T2	2486	42.83	4414	85.18
Gleason score risk group					<0.0001
Moderately differentiated	2719	46.85	3193	61.62
Poorly differentiated	3085	53.15	1989	38.38
Year at diagnosis					<0.0001
1998	95	1.64	217	4.19
1999	95	1.64	202	3.90
2000	226	3.89	348	6.72
2001	223	3.84	424	8.18
2002	264	4.55	429	8.28
2003	437	7.53	330	6.37
2004	1352	23.29	1006	19.41
2005	1118	19.26	821	15.84
2006	1153	19.87	708	13.66
2007	841	14.49	697	13.45
Region					<0.0001
North-central	794	13.68	756	14.59
Northeast	1710	29.46	613	11.83
South	1336	23.02	919	17.73
West	1964	33.84	2894	55.85
CCI group					<0.0001
0	2329	40.13	3064	59.13
≤2	2264	39.01	1693	32.67
>2	1211	20.86	425	8.20
Hypertension					<0.0001
No	1057	18.21	1400	27.02
Yes	4747	81.79	3782	72.98
Diabetes					<0.0001
No	3474	59.86	3787	73.08
Yes	2330	40.14	1395	26.92
Hospitalization					<0.0001
No	4758	81.98	4715	90.99
Yes	1046	18.02	467	9.01
Outpatient visit					0.9922
No	1581	27.24	1412	27.25
Yes	4223	72.76	3770	72.75
Surgery					<0.0001
No	5046	86.94	4842	93.44
Yes	758	13.06	340	6.56

Abbreviations: PADT, primary androgen-deprivation treatment; RP, radical prostatectomy; PSA, prostate-specific antigen; CCI, Charlson comorbidity index.

Table 2 Baseline information between PADT and RP cohorts after propensity score-matching

	PADT		RP		P
	n	%	n	%
	1624	100	1624	100
Race					0.8898
Not white	299	18.41	296	18.23
White	1325	81.59	1328	81.77
Married					0.3691
No	396	24.38	418	25.74
Yes	1228	75.62	1206	74.26
Urban residence					0.3640
No	199	12.25	184	11.33
Yes	1425	87.75	1440	88.67
PSA					1.000
Low	841	51.79	841	51.79
Median	126	7.76	126	7.76
High	53	3.26	53	3.26
Positive	372	22.91	372	22.91
Unknown	232	14.29	232	14.29
T-score					0.9306
T1	343	21.12	341	21.00
T2	1281	78.88	1283	79.00
Gleason score risk group					0.6740
Moderately/well differentiated	814	50.12	826	50.86
Poorly differentiated	810	49.88	798	49.14
Year at diagnosis					1.000
1998	26	1.60	26	1.60
1999	30	1.85	30	1.85
2000	85	5.23	85	5.23
2001	89	5.48	89	5.48
2002	97	5.97	97	5.97
2003	114	7.02	114	7.02
2004	369	22.72	369	22.72
2005	323	19.89	323	19.89
2006	279	17.18	279	17.18
2007	212	13.05	212	13.05
Region					0.9202
North-central	247	15.21	235	14.47
Northeast	287	17.67	283	17.43
South	333	20.50	333	20.50
West	757	46.61	773	47.60
CCI group					0.5710
0	833	51.29	803	49.45
≤2	609	37.50	634	39.04
>2	182	11.21	187	11.51
Hypertension					0.4510
No	390	24.01	383	23.58
Yes	1234	75.99	1241	76.42
Diabetes					0.7726
No	1113	68.53	1093	67.30
Yes	511	31.47	531	32.70
Hospitalization					0.5831
No	1444	88.92	1434	88.30
Yes	180	11.08	190	11.70
Outpatient use					0.5171
No	436	26.85	452	27.83
Yes	1188	73.15	1172	72.17
Surgery					0.9491
No	1496	92.12	1497	92.18
Yes	128	7.88	127	7.82

Abbreviations: PADT, primary androgen-deprivation treatment; RP, radical prostatectomy; PSA, prostate-specific antigen; CCI, Charlson comorbidity index.

Figure 1 The Kaplan–Meier curve of overall survival between the primary androgen-deprivation treatment (PADT) and radical prostatectomy (RP) cohorts after propensity score-matching.

Table 3 Cox proportional hazards regression on overall survival between the PADT and RP cohorts after propensity score-matching

	HR	Lower 95% CI	Higher 95% CI	P
PADT	2.98	2.35	3.79	<0.001
Age at diagnosis	1.03	0.99	1.08	0.154
White	0.80	0.62	1.02	0.073
Married	0.77	0.61	0.97	0.026
Urban	0.74	0.54	1.02	0.065
Region
Northeast	1.14	0.75	1.74	0.548
South	1.19	0.82	1.71	0.359
West	1.17	0.84	1.63	0.354
PSA
Low	0.76	0.43	1.33	0.339
Median	1.20	0.61	2.36	0.606
High	1.30	0.59	2.86	0.516
Unknown	1.30	0.89	1.89	0.179
T2	1.33	1.00	1.76	0.046
Worse Gleason score	1.29	1.02	1.62	0.032
CCI
≤2	1.66	1.27	2.17	<0.001
>2	2.21	1.51	3.22	<0.001
Diabetes (yes)	0.98	0.76	1.26	0.886
CVD history	1.14	0.98	1.31	0.088
Year at diagnosis
1998	0.01	0.01	0.03	<0.001
1999	0.03	0.01	0.09	<0.001
2000	0.03	0.01	0.08	<0.001
2001	0.07	0.03	0.17	<0.001
2002	0.09	0.04	0.22	<0.001
2003	0.11	0.05	0.27	<0.001
2004	0.08	0.04	0.17	<0.001
2005	0.16	0.08	0.32	<0.001
2006	0.30	0.15	0.59	0.001
Hospitalization (yes)	1.81	1.17	2.80	0.007
Surgery (yes)	0.86	0.53	1.39	0.531
Outpatient use (yes)	1.18	0.90	1.54	0.223
Hypertension (yes)	1.12	0.85	1.48	0.420

Abbreviations: PADT, primary androgen-deprivation treatment; RP, radical prostatectomy; HR, hazard ratio; CI, confidence interval; PSA, prostate-specific antigen; CCI, Charlson comorbidity index; CVD, cardiovascular disease.

Figure 2 The cumulative incidence curve of prostate cancer-specific mortality between the primary androgen-deprivation treatment (PADT) and radical prostatectomy (RP) cohorts after propensity score-matching.

Table 4 Competing risk analysis of prostate cancer-specific survival between the PADT and RP cohorts after propensity score-matching

	HR	Lower 95% CI	Higher 95% CI	P
PADT	12.47	4.48	34.7	<0.001
Age at diagnosis	0.96	0.86	1.07	0.45
White	0.94	0.49	1.82	0.86
Married	0.86	0.48	1.51	0.59
Region
Northeast	1.59	0.58	4.38	0.37
South	1.08	0.43	2.71	0.86
West	1.27	0.58	2.76	0.55
Urban	0.53	0.28	1.00	0.05
PSA
Positive	2.68	0.58	12.27	0.21
Median	2.43	0.71	8.38	0.16
High	1.23	0.15	9.96	0.84
Unknown	2.43	0.79	7.49	0.12
T2	1.71	0.86	3.42	0.13
Worse Gleason score	3.16	1.77	5.64	<0.001
Year at diagnosis
1998	0.40	0.04	4.47	0.46
1999	0.45	0.05	4.50	0.50
2000	0.43	0.05	3.68	0.45
2001	0.40	0.04	3.65	0.41
2002	0.67	0.08	5.27	0.70
2003	0.29	0.03	2.46	0.25
2004	0.24	0.05	1.13	0.07
2005	0.31	0.06	1.58	0.16
2006	0.37	0.06	2.45	0.31
CCI ≤ 2	0.82	0.40	1.68	0.59
CCI > 2	1.12	0.35	3.65	0.85
Hospitalization (yes)	1.89	0.80	4.46	0.14
Surgery (yes)	1.02	0.33	3.15	0.97
Outpatient use (yes)	1.58	0.81	3.07	0.18
Hypertension (yes)	1.01	0.55	1.83	0.98
Diabetes (yes)	0.96	0.46	2.02	0.92
CVD history	0.86	0.55	1.34	0.49

Abbreviations: PADT, primary androgen-deprivation treatment; RP, radical prostatectomy; HR, hazard ratio; CI, confidence interval; PSA, prostate-specific antigen; CCI, Charlson comorbidity index; CVD, cardiovascular disease.