Evidence map›Paper›PMID 27720537›Full record

ArticleEuropean urology2017

Mortality Among Men with Advanced Prostate Cancer Excluded from the ProtecT Trial.

Thomas J Johnston, Greg L Shaw, Alastair D Lamb, Deepak Parashar, David Greenberg, Tengbin Xiong, Alison L Edwards, Vincent Gnanapragasam, Peter Holding, Phillipa Herbert and 23 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European urology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed.

  1. Trial
  2. Trial
  3. A Metastasis-competent CAF Subpopulation Defined byRecent patents on anti-cancer drug discovery · 2026
    Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Observational
  9. Review
  10. Review
  11. Article
  12. Review
  13. Review
  14. Neoadjuvant Therapy in High-Risk Prostate Cancer.Indian journal of urology : IJU : journal of the Urological Society of India
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

33 authors.

Thomas J JohnstonAcademic Urology Group, University of Cambridge, Cambridge, UK. Electronic address: thomasjohnston1@nhs.net.
Greg L ShawAcademic Urology Group, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK.
Alastair D LambAcademic Urology Group, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK.
Deepak ParasharStatistics and Epidemiology Unit & Cancer Research Centre, University of Warwick, Coventry, UK.
David GreenbergNational Cancer Registration Service - Eastern Office, Public Health England, Cambridge, UK.
Tengbin XiongAcademic Urology Group, University of Cambridge, Cambridge, UK.
Alison L EdwardsAcademic Urology Group, University of Cambridge, Cambridge, UK.
Vincent GnanapragasamAcademic Urology Group, University of Cambridge, Cambridge, UK.
Peter HoldingNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Phillipa HerbertAcademic Urology Group, University of Cambridge, Cambridge, UK.
Michael DavisSchool of Social and Community Medicine, University of Bristol, Bristol, UK.
Elizabeth MizielinskSchool of Social and Community Medicine, University of Bristol, Bristol, UK.
J Athene LaneSchool of Social and Community Medicine, University of Bristol, Bristol, UK.
Jon OxleyDepartment of Cellular Pathology, North Bristol NHS Trust, Bristol, UK.
Mary RobinsonDepartment of Cellular Pathology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK.
Malcolm MasonDivision of Cancer and Genetics, School of Medicine, Cardiff University, Cardiff, UK.
John StaffurthDivision of Cancer and Genetics, School of Medicine, Cardiff University, Cardiff, UK.
Prasad BollinaDepartment of Urology and Surgery, Western General Hospital, University of Edinburgh, Edinburgh, UK.
James CattoAcademic Urology Unit, University of Sheffield, Sheffield, UK.
Andrew DobleDepartment of Urology, Addenbrooke's Hospital, Cambridge, UK.
Alan DohertyDepartment of Urology, Queen Elizabeth Hospital, Birmingham, UK.
David GillattDepartment of Urology, Southmead Hospital and Bristol Urological Institute, Bristol, UK.
Roger KockelberghDepartment of Urology, University Hospitals of Leicester, Leicester, UK.
Howard KynastonDepartment of Urology, Cardiff and Vale University Health Board, Cardiff, UK.
Steve PrescottDepartment of Urology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Alan PaulDepartment of Urology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Philip PowellDepartment of Urology, Freeman Hospital, Newcastle-upon-Tyne, UK.
Derek RosarioAcademic Urology Unit, University of Sheffield, Sheffield, UK.
Edward RoweDepartment of Urology, Southmead Hospital and Bristol Urological Institute, Bristol, UK.
Jenny L DonovanSchool of Social and Community Medicine, University of Bristol, Bristol, UK.
Freddie C HamdyNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
David E NealAcademic Urology Group, University of Cambridge, Cambridge, UK; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK. Electronic address: den22@cam.ac.uk.
ProtecT study group

Funding

Cancer Research UKProstate Cancer UK PA14-022
6 · The paper itself

Abstract

backgroundEarly detection and treatment of asymptomatic men with advanced and high-risk prostate cancer (PCa) may improve survival rates.

objectiveTo determine outcomes for men diagnosed with advanced PCa following prostate-specific antigen (PSA) testing who were excluded from the ProtecT randomised trial. DESIGN, SETTING, AND

participantsMortality was compared for 492 men followed up for a median of 7.4 yr to a contemporaneous cohort of men from the UK Anglia Cancer Network (ACN) and with a matched subset from the ACN. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: PCa-specific and all-cause mortality were compared using Kaplan-Meier analysis and Cox's proportional hazards regression. RESULTS AND LIMITATIONS: Of the 492 men excluded from the ProtecT cohort, 37 (8%) had metastases (N1, M0=5, M1=32) and 305 had locally advanced disease (62%). The median PSA was 17μg/l. Treatments included radical prostatectomy (RP; n=54; 11%), radiotherapy (RT; n=245; 50%), androgen deprivation therapy (ADT; n=122; 25%), other treatments (n=11; 2%), and unknown (n=60; 12%). There were 49 PCa-specific deaths (10%), of whom 14 men had received radical treatment (5%); and 129 all-cause deaths (26%). In matched ProtecT and ACN cohorts, 37 (9%) and 64 (16%), respectively, died of PCa, while 89 (22%) and 103 (26%) died of all causes. ProtecT men had a 45% lower risk of death from PCa compared to matched cases (hazard ratio 0.55, 95% confidence interval 0.38-0.83; p=0.0037), but mortality was similar in those treated radically. The nonrandomised design is a limitation.

conclusionsMen with PSA-detected advanced PCa excluded from ProtecT and treated radically had low rates of PCa death at 7.4-yr follow-up. Among men who underwent nonradical treatment, the ProtecT group had a lower rate of PCa death. Early detection through PSA testing, leadtime bias, and group heterogeneity are possible factors in this finding. PATIENT SUMMARY: Prostate cancer that has spread outside the prostate gland without causing symptoms can be detected via prostate-specific antigen testing and treated, leading to low rates of death from this disease.

Indexed as

MortalityAgedAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedAntineoplastic Agents, HormonalCause of DeathCohort StudiesEarly Detection of CancerEligibility DeterminationHumansKallikreinsMaleMiddle AgedNeoplasm MetastasisProstatectomyProstate-Specific AntigenAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedAntineoplastic Agents, HormonalcixutumumabKallikreinsKLK3 protein, humanProstate-Specific AntigenProstate cancerProstate-specific antigen screeningSurvival

Identifiers

PMID27720537
PMCPMC5289293

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.