## Survival

The following figures mainly present the relative survival (RS) curves, an estimator for the cancer specific survival. This is calculated by dividing the overall survival (OS) of the observed cohort by the expected survival of a normal population with the same distribution regarding birth-date and sex.

When looking at the influence of the year of diagnosis on the overall survival (Figure 5) or relative survival (Figure 6) only the curve of patients with a diagnosis in the years 1998 until 1992 noticeably differs from the other ones. Here the 5- and 10-year relative survival was 85.0% and 74.3%, respectively. In the group of patients diagnosed between 1993 and 1997 the 5- and 10-year relative survival was 94.9% and 88.6% in the group of 1998-2002 the 5-and 10-year relative survival was 94.0% and 84.1% and in the recent group of 2003-2008 the 5-year relative survival was 92.1%. Therefore, the following survival analyses are presented for patients with a diagnosis between 1998 - 2008.

Figure 5. Overall survival by year of diagnosis (n=30902) [4]

Years

Figure 5. Overall survival by year of diagnosis (n=30902) [4]

Figure 6. Relative survival by year of diagnosis (n=30902) [4]. Relative survival is the quotient of overall survival and expected survival and thus an estimator for the cancer specific survival.

Years

Figure 6. Relative survival by year of diagnosis (n=30902) [4]. Relative survival is the quotient of overall survival and expected survival and thus an estimator for the cancer specific survival.

The complete cohort of prostate cancer patients with a diagnosis between 1998 and 2008 (Figure 7) shows a 5-year overall survival of 78.8% and a 10-year overall survival of 57.7%. The relative survival is 93.6% and 84.1%, respectively. For comparison: SEER data show a 5-year relative survival of 99.2% for patients diagnosed between 2002 and 2008 and a 10-year relative survival of 98.3% for the cohort of 1998 - 2008.

Figure 8 presents the relative survival by the combined T category. As expected, patients with a T2-staging perform better than patients with a T1-Staging. The 5- and 10-year relative survival is 102.0% and 94.0% in T1, 104.9% and 108.8% in T2, 97.6% and 89.5% in T3 and 61.4% and 43.8% in T4, respectively. Relative survival can exceed 100%, because prostate cancer patients benefit from the better treatment of comorbidities during aftercare.

Lymph node status (N category) is an important prognostic factor. As Figure 9 shows, a positive lymph node status (N+) reduces the relative survival drastically (77.7% for 5-year and 61.9% for 10-year survival) compared to a 5- and 10-year survival of 105.5% and 107.5% in N0. Nonetheless, prostate cancer patients benefit from radical prostatectomy in the situation with lymph node metastases [10].

Overall Survival Relative Survival Expected Survival

Figure 7. Overall, relative and expected survival of the complete collective (1998-2008, n = 25773) [4]. Relative survival is the quotient of overall survival and expected survival and thus an estimator for the cancer specific survival.

Overall Survival Relative Survival Expected Survival

Figure 7. Overall, relative and expected survival of the complete collective (1998-2008, n = 25773) [4]. Relative survival is the quotient of overall survival and expected survival and thus an estimator for the cancer specific survival.

Years

Figure 8. Relative Survival by T category (1998-2008, n = 20685) [4]. T category is a combination of cT and pT.

Figure 10. Relative survival by Gleason Score (1998-2008, n = 21759) [4]

Years

Figure 10. Relative survival by Gleason Score (1998-2008, n = 21759) [4]

Figure 11. Post Progression Survival (1998-2008, n = 2223) [4]. Starting point of progression is from date of locore-gional relapse or distant metastasis (primary Ml or metastases in further course of disease).

Years

Figure 11. Post Progression Survival (1998-2008, n = 2223) [4]. Starting point of progression is from date of locore-gional relapse or distant metastasis (primary Ml or metastases in further course of disease).

According to Figure 10 patients with the worst Gleason Score category (8 - 10) have a much poorer survival (73.4% for five year and 55.0% for ten year survival) than patients with a scoring of 7 and better, which does not discriminate very much (104.1% and 94.8% for Gleason Score 2 - 4, 102.2% and 98.6% for Gleason Score 5 - 6 and 98.6% and 91.8% for Gleason Score 7).

If the tumour has metastasised or locoregional recurrence has occurred, only 18.2% of the patients survive 5 years and 7.2% of the patients survive 10 years. The median survival is about two years (Figure 11).

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