Might Men Diagnosed with Metastatic Prostate Cancer Benefit from Definitive Treatment of the Primary Tumor? A SEER-Based Study  Stephen H. Culp, Paul F. Schellhammer, Michael B. Williams  European Urology  Volume 65, Issue 6, Pages 1058-1066 (June 2014) DOI: 10.1016/j.eururo.2013.11.012 Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 1 (A) Overall survival and (B) cumulative incidence of prostate cancer (PCa)-specific mortality in patients with metastatic PCa at diagnosis based on treatment received. For cumulative incidence of cancer-specific mortality, analyses are adjusted for age at diagnosis; race; initial prostate-specific antigen; tumor grade; American Joint Committee on Cancer T, N, and M stages; year of diagnosis; and registry, and account for the competing risk of non-PCa death. NSR=no surgery or radiation therapy; RP=radical prostatectomy; BT=brachytherapy. European Urology 2014 65, 1058-1066DOI: (10.1016/j.eururo.2013.11.012) Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 2 Survival of patients with metastatic prostate cancer (PCa) at diagnosis undergoing local therapy (LT) based on the number of factors independently associated with an increase in PCa-specific mortality: T4 or high-grade disease, age ≥70 yr, PSA ≥20 ng/ml, and pelvic lymphadenopathy. (A) Kaplan-Meier analysis demonstrating overall survival; (B) cumulative incidence of PCa-specific mortality, accounting for the competing risk of non-PCa and adjusted for race, American Joint Committee on Cancer M stage, year of diagnosis, and registry. Patients undergoing no surgery or radiation therapy (NSR) are listed as a reference. European Urology 2014 65, 1058-1066DOI: (10.1016/j.eururo.2013.11.012) Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 3 Overall survival (left column) and cumulative incidence of prostate cancer (PCa)-specific mortality (right column) in patients with metastatic PCa at diagnosis based on age ([A] <70 yr and [B] ≥70 yr) and treatment received. For cumulative incidence of cancer-specific mortality, analyses are adjusted for race; prostate-specific antigen; tumor grade; American Joint Committee on Cancer T, N, and M stages; year of diagnosis; and registry, and account for the competing risk of non–PCa death. NSR=no surgery or radiation therapy; RP=radical prostatectomy; BT=brachytherapy. European Urology 2014 65, 1058-1066DOI: (10.1016/j.eururo.2013.11.012) Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 4 Overall survival (left column) and cumulative incidence of prostate cancer (PCa)-specific mortality (right column) in patients with metastatic PCa at diagnosis based on prostate-specific antigen level ([A] <20 ng/ml and [B] ≥20 ng/ml) and treatment received. For cumulative incidence of cancer-specific mortality, analyses are adjusted for race; age; tumor grade; American Joint Committee on Cancer T, N, and M stages; year of diagnosis; and registry and account for the competing risk of non-PCa death. NSR=no surgery or radiation therapy; RP=radical prostatectomy; BT=brachytherapy (BT). European Urology 2014 65, 1058-1066DOI: (10.1016/j.eururo.2013.11.012) Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 5 Overall survival (left column) and cumulative incidence of prostate cancer (PCa)–specific mortality (right column) in patients with metastatic PCa at diagnosis based on American Joint Committee on Cancer M stage [M1a, M1b, or M1c] and treatment received. For cumulative incidence of cancer-specific mortality, analyses are adjusted for age, race, prostate-specific antigen, tumor grade, AJCC T and N stages, year of diagnosis, and registry, and account for the competing risk of non-PCa death. NSR=no surgery or radiation therapy; RP=radical prostatectomy; BT=brachytherapy. European Urology 2014 65, 1058-1066DOI: (10.1016/j.eururo.2013.11.012) Copyright © 2013 European Association of Urology Terms and Conditions