Survival Benefit of Radical Prostatectomy in Newly Diagnosed Metastatic Prostate Cancer Varies by PSA Level and Site of Metastasis
Background In patients with newly diagnosed metastatic prostate cancer (mPCa), the appropriate population for radical prostatectomy (RP) remains unclear.Patients and methods Newly diagnosed mPCa patients were identified from the Surveillance, Epidemiology, and End Results (SEER) database and divided...
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Taylor & Francis Group
2025-12-01
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| Series: | Journal of Investigative Surgery |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/08941939.2025.2534579 |
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| author | Xin Zhang Sen Pan Wei Sun Chuanlin Wang |
| author_facet | Xin Zhang Sen Pan Wei Sun Chuanlin Wang |
| author_sort | Xin Zhang |
| collection | DOAJ |
| description | Background In patients with newly diagnosed metastatic prostate cancer (mPCa), the appropriate population for radical prostatectomy (RP) remains unclear.Patients and methods Newly diagnosed mPCa patients were identified from the Surveillance, Epidemiology, and End Results (SEER) database and divided into no local therapy (NLT) and RP groups. Propensity score matching (PSM) was used to balance baseline characteristics. Kaplan-Meier curves were used to estimate cancer-specific survival (CSS).Results A total of 9,215 patients were included, with 8,844 receiving NLT and 371 undergoing RP. After PSM, 321 patients in each group were included. RP was associated with significantly better CSS (HR = 0.38, 95% CI, 0.27–0.54, p < 0.001). Subgroup analyses showed consistent survival benefit of RP except in patients with M1c disease (HR = 0.55, 95% CI, 0.21–1.46, p = 0.229) or PSA ≥60 ng/ml (HR = 1.19, 95% CI, 0.53–2.86, p = 0.673). An exploratory classification defined low tumor burden as PSA <60 ng/ml and M1a/M1b disease, and high tumor burden as PSA ≥60 ng/ml or M1c. RP significantly improved CSS in the low tumor burden group (HR = 0.30, 95% CI, 0.20–0.46, p < 0.001), but not in the high tumor burden group (HR = 0.98, 95% CI, 0.53–1.84, p = 0.961).Conclusion In patients with newly diagnosed mPCa, the survival benefit of RP varies with tumor burden. |
| format | Article |
| id | doaj-art-74d13d20b3684bd69116ff56c07fd735 |
| institution | DOAJ |
| issn | 0894-1939 1521-0553 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj-art-74d13d20b3684bd69116ff56c07fd7352025-08-20T03:08:32ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532025-12-0138110.1080/08941939.2025.2534579Survival Benefit of Radical Prostatectomy in Newly Diagnosed Metastatic Prostate Cancer Varies by PSA Level and Site of MetastasisXin Zhang0Sen Pan1Wei Sun2Chuanlin Wang3Department of Urology, Chongqing University Fuling Hospital, Chongqing, P.R. ChinaDepartment of Urology, Chongqing University Fuling Hospital, Chongqing, P.R. ChinaDepartment of Urology, Chongqing University Fuling Hospital, Chongqing, P.R. ChinaDepartment of Urology, Chongqing University Fuling Hospital, Chongqing, P.R. ChinaBackground In patients with newly diagnosed metastatic prostate cancer (mPCa), the appropriate population for radical prostatectomy (RP) remains unclear.Patients and methods Newly diagnosed mPCa patients were identified from the Surveillance, Epidemiology, and End Results (SEER) database and divided into no local therapy (NLT) and RP groups. Propensity score matching (PSM) was used to balance baseline characteristics. Kaplan-Meier curves were used to estimate cancer-specific survival (CSS).Results A total of 9,215 patients were included, with 8,844 receiving NLT and 371 undergoing RP. After PSM, 321 patients in each group were included. RP was associated with significantly better CSS (HR = 0.38, 95% CI, 0.27–0.54, p < 0.001). Subgroup analyses showed consistent survival benefit of RP except in patients with M1c disease (HR = 0.55, 95% CI, 0.21–1.46, p = 0.229) or PSA ≥60 ng/ml (HR = 1.19, 95% CI, 0.53–2.86, p = 0.673). An exploratory classification defined low tumor burden as PSA <60 ng/ml and M1a/M1b disease, and high tumor burden as PSA ≥60 ng/ml or M1c. RP significantly improved CSS in the low tumor burden group (HR = 0.30, 95% CI, 0.20–0.46, p < 0.001), but not in the high tumor burden group (HR = 0.98, 95% CI, 0.53–1.84, p = 0.961).Conclusion In patients with newly diagnosed mPCa, the survival benefit of RP varies with tumor burden.https://www.tandfonline.com/doi/10.1080/08941939.2025.2534579prostate cancermetastasisradical prostatectomySEER databasecancer-specific survival |
| spellingShingle | Xin Zhang Sen Pan Wei Sun Chuanlin Wang Survival Benefit of Radical Prostatectomy in Newly Diagnosed Metastatic Prostate Cancer Varies by PSA Level and Site of Metastasis Journal of Investigative Surgery prostate cancer metastasis radical prostatectomy SEER database cancer-specific survival |
| title | Survival Benefit of Radical Prostatectomy in Newly Diagnosed Metastatic Prostate Cancer Varies by PSA Level and Site of Metastasis |
| title_full | Survival Benefit of Radical Prostatectomy in Newly Diagnosed Metastatic Prostate Cancer Varies by PSA Level and Site of Metastasis |
| title_fullStr | Survival Benefit of Radical Prostatectomy in Newly Diagnosed Metastatic Prostate Cancer Varies by PSA Level and Site of Metastasis |
| title_full_unstemmed | Survival Benefit of Radical Prostatectomy in Newly Diagnosed Metastatic Prostate Cancer Varies by PSA Level and Site of Metastasis |
| title_short | Survival Benefit of Radical Prostatectomy in Newly Diagnosed Metastatic Prostate Cancer Varies by PSA Level and Site of Metastasis |
| title_sort | survival benefit of radical prostatectomy in newly diagnosed metastatic prostate cancer varies by psa level and site of metastasis |
| topic | prostate cancer metastasis radical prostatectomy SEER database cancer-specific survival |
| url | https://www.tandfonline.com/doi/10.1080/08941939.2025.2534579 |
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