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Introduction: Conditional survival is defined as the likelihood of subsequent survival, given the pre-condition of having already survived malignancy for certain duration. We evaluated whether biochemical recurrence (BCR) free duration is associated with
conditional cancer specific survival (CCSS) following radical prostatectomy (RP) for prostate cancer according to D’Amico risk classification.
Materials & Methods:Between 1984 and 2013, 13,442 men who underwent RP and had complete follow-up data were analyzed. Using Kaplan-Meier estimates, 10-year CCSS probabilities following RP were estimated in men who were free from BCR at postoperative years zero through seven. CCSS was analyzed by D’Amico risk group and compared using the log-rank test.
Results:Median follow-up after RP was 10 years. Ten-year
CCSS rates in the low- and intermediate-risk men were consistently higher than 98%, regardless of the duration of BCR-free interval. Among high-risk men, 10-year CCSS rates improved with increasing BCR-free interval: from 91.0% after BCR-free
duration of zero, to 99.1% after BCR-free duration of 4 years, to 99.7% after BCR free duration of seven years. After BCR-free duration of seven years, there was no difference in CCSS among D’Amico risk classification strata.
Conclusions: CCSS rates following RP were excellent in low- and
intermediate-risk men, regardless of the duration of the BCR-free interval. In high-risk men, 10-year CCSS improved gradually as a function of BCR-free duration after RP. After a BCR-free duration of 7 years after RP, there was no difference in CCSS between low- and high-risk patients.