Implications of the prostate cancer prevention trial: A decision analysis model of survival outcomes

Yair Lotan, Jeffrey A Cadeddu, J. Jack Lee, Claus Roehrborn, Scott M. Lippman

Research output: Contribution to journalArticle

27 Citations (Scopus)

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 abstracted 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 (v those 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.

Original languageEnglish (US)
Pages (from-to)1911-1920
Number of pages10
JournalJournal of Clinical Oncology
Volume23
Issue number9
DOIs
StatePublished - 2005

Fingerprint

Finasteride
Decision Support Techniques
Prostatic Neoplasms
Survival
Neoplasm Grading
Placebos
Biopsy
Decision Trees
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Implications of the prostate cancer prevention trial : A decision analysis model of survival outcomes. / Lotan, Yair; Cadeddu, Jeffrey A; Lee, J. Jack; Roehrborn, Claus; Lippman, Scott M.

In: Journal of Clinical Oncology, Vol. 23, No. 9, 2005, p. 1911-1920.

Research output: Contribution to journalArticle

@article{0b6274dd4e4146e98460114867d702f0,
title = "Implications of the prostate cancer prevention trial: A decision analysis model of survival outcomes",
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 abstracted 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 (v those 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.",
author = "Yair Lotan and Cadeddu, {Jeffrey A} and Lee, {J. Jack} and Claus Roehrborn and Lippman, {Scott M.}",
year = "2005",
doi = "10.1200/JCO.2005.03.137",
language = "English (US)",
volume = "23",
pages = "1911--1920",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "9",

}

TY - JOUR

T1 - Implications of the prostate cancer prevention trial

T2 - A decision analysis model of survival outcomes

AU - Lotan, Yair

AU - Cadeddu, Jeffrey A

AU - Lee, J. Jack

AU - Roehrborn, Claus

AU - Lippman, Scott M.

PY - 2005

Y1 - 2005

N2 - 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 abstracted 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 (v those 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.

AB - 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 abstracted 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 (v those 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.

UR - http://www.scopus.com/inward/record.url?scp=15744371131&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=15744371131&partnerID=8YFLogxK

U2 - 10.1200/JCO.2005.03.137

DO - 10.1200/JCO.2005.03.137

M3 - Article

C2 - 15774783

AN - SCOPUS:15744371131

VL - 23

SP - 1911

EP - 1920

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 9

ER -