OBJECTIVES: Prostate cancer (PC) is one of the first most common malignancy in men and the second most common leading source of cancer deaths in Europe. The majority of the patients undergoing radical prostatectomy (RP) are under the age of 70 years. In this study we examined overall survival of patients with RP and compared to an age-matched general population of patients with PC.

METHODS: We performed a retrospective cohort study from 2002 to 2013 using the database of the Hungarian National Health Insurance Found Administration which comprises longitudinal claims data for the whole population. Patients with PC were selected through a multi-step process based on international classification codes of PC and having either androgen-deprivation therapy or radical prostatectomy or radiotherapy. RP patients were matched 1:1 to general PC controls with no RP via propensity score matching to balance age and presence of bone metastasis. We compared overall survival using Kaplan-Meier method and Cox regression model.

RESULTS: Altogether 50,392 men with prostate cancer were identified during the whole study period and 5,590 of them had RP. In patients with and without RP, mean (SD) age was 60.5 (6.1) and 71.9 (8.5) years and 221 (4.0%) and 3,170 (7.1%) patients had bone metastasis, respectively. In the matched control sample (n=5,590), mean age was 60.5 (6.0) years and 231 (4.1%) patients had bone metastasis. Our results showed that RP had better survival benefit (Log-rank p<0.001) and improved overall 3-year (95.3% vs. 75.5%, p<0.001) and 5-year survival rates (89.8% vs. 63.9%, p < 0.001) compared to the matched sample. In multivariate analysis, RP patients showed lower (HR: 0.20; 95% CI: 0.18-0.22) and patients with bone metastasis showed higher (HR: 1.86; 95% CI: 1.61-2.16) overall mortality risk.

CONCLUSIONS: Our results showed that patients underwent RP had longer overall survival in PC.