Survival analysis in prostate cancer patients in a brazilian state and its associated factors: a retrospective cohort study

Keywords

prostate cancer - survival analysis - cox proportional hazards - hospital-based cancer registries - cohort study

Introduction: Prostate cancer (PCa) is one of the most common neoplasms worldwide and one of the main causes of premature death in men. We aimed to determine survival and identify its associated factors in a cohort of men with prostate cancer treated by hospitals in the oncology care network of a Brazilian state.

Methods: Retrospective observational cohort study using databases extracted from the hospital cancer records and the mortality information system of a Brazilian state, including 10,556 patients with prostate cancer diagnosed. Cases were divided into death from PCa, death from other causes, and alive, and we followed up for at least 5 years. Multivariate analysis was performed using the cause-specific Cox proportional hazards model. Descriptive and inferential analyses were performed in RStudio and R.

Results: At the end of 2021, the cohort had 6,388 alive, 1,936 deaths from PCa and 2,232 deaths from other causes. The 5-year overall specific survival was 87.7%. Multivariate analysis showed that age is a factor associated with the risk of specific death, with each 10-year increment at diagnosis presenting almost 16.2% more risk of specific mortality due to PCa (HR=1.162; 95%CI:1.091-1.238). They have a high risk of death from PCa if they have distant metastases (HR=5.452; 95%CI: 4.856-6.122) and if they are treated with hormone therapy (HR=1.282; 95%CI:1.141-1.441). However, there was a reduction in the risk of specific mortality due to PCa in patients with a medium or higher level of education (HR=0.748; 95%CI: 0.616-0.908) compared to illiterate patients; as well as in patients who received surgery (HR=0.363; 95%CI:0.295-0.447) and radiotherapy (HR=0.445, 95%CI:0.370-0.536).

Conclusion: Age, educational level, presence of distant metastasis, surgery, radiotherapy, and hormonal therapy were associated with the risk of specific mortality among patients with PCa, which may help in the development of personalized policies and programs for diagnosis, treatment, and follow-up for these patients.

Corresponding author: Luís Carlos Lopes-Júnior (e-mail: [e-mail]).

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
06 May 2025