Long-term survival probability in men with clinically localized prostate cancer: A case-control, propensity modeling study stratified by race, age, treatment and comorbidities

Purpose: We used a propensity risk scoring approach to model long-term survival for men with clinically localized prostate cancer. We developed comprehensive lookup tables for estimating survival probability stratified by patient age, race, readily available clinical variables, comorbidities and treatment type. Materials and Methods: We retrospectively identified a cohort of 1,611 men with clinically localized prostate cancer (patients) and 4,538 age, race and comorbidity matched controls. Based on demographic and clinical variables propensity risk scoring was used to develop smoothed survival prediction models for patients and controls. Based on these models tables were created to provide 10-year overall survival estimates. The tables are stratified by patient age, race, comorbidity, prostate specific antigen, cancer grade, and treatment type when applicable. Results: Mean patient age was 67.0 years and median baseline prostate specific antigen was 8.5 ng/ml. Of the patients 68% had biopsy cancer grade 2, 39% were black, 29% received conservative treatment, 43% underwent radical prostatectomy and 27% were treated with radiation therapy. Crude and cancer specific 10-year survival rates were 67% and 93%, respectively. Validation C-index values were 0.63 for the cancer specific model and 0.69 for the overall survival model. Conclusions: These lookup tables provide physicians and patients with realistic estimates of 10-year survival and allow them to compare the impact of cancer vs noncancer factors on patient mortality.