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Prostate cancer outcomes in France: treatments, adverse effects and two-year mortality
BACKGROUND: This very large population-based study investigated outcomes after a diagnosis of prostate cancer (PCa) in terms of mortality rates, treatments and adverse effects. METHODS: Among the 11 million men aged 40 years and over covered by the general national health insurance scheme, those wit...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4067687/ https://www.ncbi.nlm.nih.gov/pubmed/24927850 http://dx.doi.org/10.1186/1471-2490-14-48 |
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author | Tuppin, Philippe Samson, Solène Fagot-Campagna, Anne Lukacs, Bertrand Alla, François Paccaud, Fred Thalabard, Jean-Christophe Vicaut, Eric Vidaud, Michel Millat, Bertrand |
author_facet | Tuppin, Philippe Samson, Solène Fagot-Campagna, Anne Lukacs, Bertrand Alla, François Paccaud, Fred Thalabard, Jean-Christophe Vicaut, Eric Vidaud, Michel Millat, Bertrand |
author_sort | Tuppin, Philippe |
collection | PubMed |
description | BACKGROUND: This very large population-based study investigated outcomes after a diagnosis of prostate cancer (PCa) in terms of mortality rates, treatments and adverse effects. METHODS: Among the 11 million men aged 40 years and over covered by the general national health insurance scheme, those with newly managed PCa in 2009 were followed for two years based on data from the national health insurance information system (SNIIRAM). Patients were identified using hospitalisation diagnoses and specific refunds related to PCa and PCa treatments. Adverse effects of PCa treatments were identified by using hospital diagnoses, specific procedures and drug refunds. RESULTS: The age-standardised two-year all-cause mortality rate among the 43,460 men included in the study was 8.4%, twice that of all men aged 40 years and over. Among the 36,734 two-year survivors, 38% had undergone prostatectomy, 36% had been treated by hormone therapy, 29% by radiotherapy, 3% by brachytherapy and 20% were not treated. The frequency of treatment-related adverse effects varied according to age and type of treatment. Among men between 50 and 69 years of age treated by prostatectomy alone, 61% were treated for erectile dysfunction and 24% were treated for urinary disorders. The frequency of treatment for these disorders decreased during the second year compared to the first year (erectile dysfunction: 41% vs 53%, urinary disorders: 9% vs 20%). The frequencies of these treatments among men treated by external beam radiotherapy alone were 7% and 14%, respectively. Among men between 50 and 69 years with treated PCa, 46% received treatments for erectile dysfunction and 22% for urinary disorders. For controls without PCa but treated surgically for benign prostatic hyperplasia, these frequencies were 1.5% and 6.0%, respectively. CONCLUSIONS: We report high survival rates two years after a diagnosis of PCa, but a high frequency of PCa treatment-related adverse effects. These frequencies remain underestimated, as they are based on treatments for erectile dysfunction and urinary disorders and do not reflect all functional outcomes. These results should help urologists and general practitioners to inform their patients about outcomes at the time of screening and diagnosis, and especially about potential treatment-related adverse effects. |
format | Online Article Text |
id | pubmed-4067687 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-40676872014-06-25 Prostate cancer outcomes in France: treatments, adverse effects and two-year mortality Tuppin, Philippe Samson, Solène Fagot-Campagna, Anne Lukacs, Bertrand Alla, François Paccaud, Fred Thalabard, Jean-Christophe Vicaut, Eric Vidaud, Michel Millat, Bertrand BMC Urol Research Article BACKGROUND: This very large population-based study investigated outcomes after a diagnosis of prostate cancer (PCa) in terms of mortality rates, treatments and adverse effects. METHODS: Among the 11 million men aged 40 years and over covered by the general national health insurance scheme, those with newly managed PCa in 2009 were followed for two years based on data from the national health insurance information system (SNIIRAM). Patients were identified using hospitalisation diagnoses and specific refunds related to PCa and PCa treatments. Adverse effects of PCa treatments were identified by using hospital diagnoses, specific procedures and drug refunds. RESULTS: The age-standardised two-year all-cause mortality rate among the 43,460 men included in the study was 8.4%, twice that of all men aged 40 years and over. Among the 36,734 two-year survivors, 38% had undergone prostatectomy, 36% had been treated by hormone therapy, 29% by radiotherapy, 3% by brachytherapy and 20% were not treated. The frequency of treatment-related adverse effects varied according to age and type of treatment. Among men between 50 and 69 years of age treated by prostatectomy alone, 61% were treated for erectile dysfunction and 24% were treated for urinary disorders. The frequency of treatment for these disorders decreased during the second year compared to the first year (erectile dysfunction: 41% vs 53%, urinary disorders: 9% vs 20%). The frequencies of these treatments among men treated by external beam radiotherapy alone were 7% and 14%, respectively. Among men between 50 and 69 years with treated PCa, 46% received treatments for erectile dysfunction and 22% for urinary disorders. For controls without PCa but treated surgically for benign prostatic hyperplasia, these frequencies were 1.5% and 6.0%, respectively. CONCLUSIONS: We report high survival rates two years after a diagnosis of PCa, but a high frequency of PCa treatment-related adverse effects. These frequencies remain underestimated, as they are based on treatments for erectile dysfunction and urinary disorders and do not reflect all functional outcomes. These results should help urologists and general practitioners to inform their patients about outcomes at the time of screening and diagnosis, and especially about potential treatment-related adverse effects. BioMed Central 2014-06-13 /pmc/articles/PMC4067687/ /pubmed/24927850 http://dx.doi.org/10.1186/1471-2490-14-48 Text en Copyright © 2014 Tuppin et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Tuppin, Philippe Samson, Solène Fagot-Campagna, Anne Lukacs, Bertrand Alla, François Paccaud, Fred Thalabard, Jean-Christophe Vicaut, Eric Vidaud, Michel Millat, Bertrand Prostate cancer outcomes in France: treatments, adverse effects and two-year mortality |
title | Prostate cancer outcomes in France: treatments, adverse effects and two-year mortality |
title_full | Prostate cancer outcomes in France: treatments, adverse effects and two-year mortality |
title_fullStr | Prostate cancer outcomes in France: treatments, adverse effects and two-year mortality |
title_full_unstemmed | Prostate cancer outcomes in France: treatments, adverse effects and two-year mortality |
title_short | Prostate cancer outcomes in France: treatments, adverse effects and two-year mortality |
title_sort | prostate cancer outcomes in france: treatments, adverse effects and two-year mortality |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4067687/ https://www.ncbi.nlm.nih.gov/pubmed/24927850 http://dx.doi.org/10.1186/1471-2490-14-48 |
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