210 Background: There are known variations in cancer survival based on race and treatment choices. We report the long-term survival probability, based on race, in 16,508 men with localized prostate cancer treated either conservatively or by radiotherapy or radical prostatectomy. Methods: We extracted survival data from tumor registries of six Cancer Research Network sites in the United States. Patients were stratified into four racial groups: Caucasians, African Americans, Hispanics, and Asians. The Cox proportional-hazards regression model was used to compare long-term survival in the three treatment groups. Kaplan-Meier survival curves and competing risk analysis was also performed. Results: Survival was improved for patients who underwent radical prostatectomy compared to radiotherapy or watchful waiting. This was true for all patients combined (Table) as well as for all races individually. Radiotherapy had at least equivalent survival outcomes as watchful waiting in all groups. The differences between treatments were greater for overall survival than for prostate cancer specific survival in all groups, though the extent of the differences varied by race. Conclusions: Radical prostatectomy increases survival in men with localized prostate cancer compared to both radiotherapy and watchful waiting, especially for Caucasian men. Radiotherapy was at least equivalent to watchful waiting for all races. Racial disparities in outcome may influence treatment choices for men with clinically localized prostate cancer. [Table: see text] [Table: see text]
Long-Term Clinical Outcomes of Radical Prostatectomy versus Watchful Waiting in Localized Prostate Cancer Patients: A Systematic Review and Meta-Analysis
