{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:34:31Z","timestamp":1780360471920,"version":"3.54.1"},"reference-count":18,"publisher":"Becaris Publishing Limited","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Comp. Eff. Res."],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>\n                    <jats:bold>Aim:<\/jats:bold>\n                    This study examined the clinical outcomes of patients in the US with low\/intermediate-risk localized prostate cancer (LIR-LPC) and high-risk localized prostate cancer (HR-LPC) who received radical prostatectomy (RP) as initial treatment.\n                    <jats:bold>Materials &amp; methods:<\/jats:bold>\n                    This is a retrospective analysis of the SEER-Medicare database. Patients newly diagnosed with LPC at age of \u226565\u00a0years during 2012\u20132019 who underwent RP as initial definitive treatment and had continuous Medicare Fee-For-Service for \u226512\u00a0months prior to RP were included. Eligible patients were stratified into LIR-LPC and HR-LPC cohorts. Overall survival, metastatic free survival and time to advanced prostate cancer treatment (TTAT) were described and compared using the Kaplan\u2013Meier method and Cox proportional-hazards model.\n                    <jats:bold>Results:<\/jats:bold>\n                    The LIR-LPC cohort (n\u00a0=\u00a04120) and the HR-LPC cohort (n\u00a0=\u00a05359) had comparable socio-demographic characteristics, with a mean age of approximately 70\u00a0years. Survival analysis showed that HR-LPC was associated with significantly shorter overall survival, metastatic free survival and TTAT than LIR-LPC (log rank p\u00a0&lt;\u00a00.001). After adjusting for comprehensive socio-demographic and baseline clinical characteristics, patients with HR-LPC had an approximately 70% increased risk for all-cause death (hazard ratio [HR]: 1.72; confidence interval [CI]:1.39\u20132.12), 2.5-fold increased risk for metastasis or death (HR: 2.57; CI: 2.14\u20133.09), and ninefold increased risk for initiating advanced treatments (HR: 9.06; CI: 6.22\u201313.18) compared with patients with LIR-LPC.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    In patients with LPC who received RP as initial definitive treatment, high risk is strongly associated with suboptimal clinical outcomes. Novel therapeutic approaches are needed to enhance the management and improve the outcomes for this patient population.\n                  <\/jats:p>","DOI":"10.57264\/cer-2025-0004","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T10:50:43Z","timestamp":1771239043000},"source":"Crossref","is-referenced-by-count":2,"title":["Real-world clinical outcomes of patients with localized prostate cancer treated with radical prostatectomy in SEER-Medicare"],"prefix":"10.57264","volume":"15","author":[{"given":"Lawrence","family":"Karsh","sequence":"first","affiliation":[{"name":"The Urology Center of Colorado, Denver, CO 80211, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2896-7873","authenticated-orcid":false,"given":"Shawn","family":"Du","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson, Horsham, PA 19044, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinghua","family":"He","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson, Horsham, PA 19044, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal","family":"Shore","sequence":"additional","affiliation":[{"name":"Carolina Urologic Research Center, Myrtle Beach, SC 29572, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"36897","reference":[{"key":"e_1_3_8_3_2","volume-title":"American Cancer Society","author":"Key Statistics for Prostate Cancer | Prostate Cancer Facts","unstructured":"Key Statistics for Prostate Cancer | Prostate Cancer Facts. American Cancer Society. (Accessed: 29 March 2024). https:\/\/www.cancer.org\/cancer\/types\/prostate-cancer\/about\/key-statistics.html"},{"issue":"1","key":"e_1_3_8_4_2","first-page":"17","article-title":"Cancer statistics, 2023","volume":"73","author":"Siegel RL","year":"2023","unstructured":"Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J. Clin. 73(1), 17\u201348 (2023).","journal-title":"CA Cancer J. Clin."},{"issue":"1","key":"e_1_3_8_5_2","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s11912-021-01156-1","article-title":"The emerging role of next-generation imaging in prostate cancer","volume":"24","author":"Murthy V","year":"2022","unstructured":"Murthy V, Aggarwal R, Koo PJ. The emerging role of next-generation imaging in prostate cancer. Curr. Oncol. Rep. 24(1), 33\u201342 (2022).","journal-title":"Curr. Oncol. Rep."},{"key":"e_1_3_8_6_2","unstructured":"Prostate Cancer Version 4.2023 NCCN Clinical Practice Guidelines in Oncology. (Accessed: 20 May 2024). https:\/\/pubmed.ncbi.nlm.nih.gov\/37856213\/"},{"issue":"1","key":"e_1_3_8_7_2","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/JU.0000000000002757","article-title":"Clinically localized prostate cancer: AUA\/ASTRO Guideline, Part I: Introduction, risk assessment, staging, and risk-based management","volume":"208","author":"Eastham JA","year":"2022","unstructured":"Eastham JA, Auffenberg GB, Barocas DA Clinically localized prostate cancer: AUA\/ASTRO Guideline, Part I: Introduction, risk assessment, staging, and risk-based management. J. Urol. 208(1), 10\u201318 (2022).","journal-title":"J. Urol."},{"issue":"1","key":"e_1_3_8_8_2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/JU.0000000000002758","article-title":"Clinically localized prostate cancer: AUA\/ASTRO Guideline, Part II: Principles of active surveillance, principles of surgery, and follow-up","volume":"208","author":"Eastham JA","year":"2022","unstructured":"Eastham JA, Auffenberg GB, Barocas D Clinically localized prostate cancer: AUA\/ASTRO Guideline, Part II: Principles of active surveillance, principles of surgery, and follow-up. J. Urol. 208(1), 19\u201325 (2022).","journal-title":"J. Urol."},{"issue":"1","key":"e_1_3_8_9_2","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/JU.0000000000002759","article-title":"Clinically localized prostate cancer: AUA\/ASTRO Guideline. 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