Titre du document / Document title

Implications of the Prostate Cancer Prevention trial: A decision analysis model of survival outcomes

Auteur(s) / Author(s)

LOTAN Yair ; CADEDDU Jeffrey A. ; LEE J. Jack ; ROEHRBORN Claus G. ; LIPPMAN Scott M. ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

Department of Urology, University of Texas Southwestern Medical Center, Dallas, ETATS-UNIS
Departments of Biostatistics and Applied Mathematics, and Clinical Cancer Prevention, University of Texas M.D. Anderson Cancer Center, Houston, TX, ETATS-UNIS

Résumé / Abstract

Purpose To assess the estimated effect of finasteride prevention of prostate cancer on overall survival. Methods Data for our decision tree model came from men in the two arms (finasteride or placebo) of the Prostate Cancer Prevention Trial (PCPT) and from clinically localized prostate cancer patients studied for long-term survival outcomes. Our model compared survival outcomes for men treated with finasteride or placebo. Prostate cancer rates were based on the 7-year period prevalence of prostate cancer detected in the PCPT; survival probabilities were ed from the long-term outcome studies. We assessed variability in the PCPT and long-term survival studies to test the variability of our model. Results Survival advantages for a finasteride-treated (vthose not treated with finasteride) population include gains of 1.7 months in 15-year cause-specific survival (assuming finasteride-altered Gleason scores and prostate cancer prevalence rates in the PCPT), of up to 3 months for cancers treated conservatively or surgically (assuming finasteride does not alter Gleason scores), and of 0.35 months (assuming the rate of cancers detected by for-cause biopsies in the PCPT), which increased to 1.7 months when assuming a 30% rate of biopsy-detected cancer in the PCPT placebo group. Model-variability analyses support several survival benefits associated with finasteride (eg, the uniform benefits assuming finasteride does not alter Gleason scores) but question certain others (eg, in 15-year recurrence-free survivals assuming finasteride does alter Gleason scores). Conclusion Finasteride can impart survival benefits according to our model, especially when we assume that finasteride does not alter Gleason scores.

Revue / Journal Title

Journal of clinical oncology   ISSN 0732-183X 

Source / Source

2005, vol. 23, n^o9, pp. 1911-1920 [10 page(s) (article)] (26 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott Williams & Wilkins, Baltimore, MD, ETATS-UNIS  (1983) (Revue)

Mots-clés anglais / English Keywords

Prostate disease ; Malignant tumor ; Urinary system disease ; Male genital diseases ; Cancerology ; Prognosis ; Survival ; Models ; Decision analysis ; Clinical trial ; Prevention ; Prostate cancer ;

Mots-clés français / French Keywords

Prostate pathologie ; Tumeur maligne ; Appareil urinaire pathologie ; Appareil génital mâle pathologie ; Cancérologie ; Pronostic ; Survie ; Modèle ; Analyse décision ; Essai clinique ; Prévention ; Cancer prostate ;

Mots-clés espagnols / Spanish Keywords

Prostata patología ; Tumor maligno ; Aparato urinario patología ; Aparato genital macho patología ; Cancerología ; Pronóstico ; Sobrevivencia ; Modelo ; Análisis decisión ; Ensayo clínico ; Prevención ; Cáncer de la próstata ;

Localisation / Location

INIST-CNRS, Cote INIST : 20094, 35400012561958.0170