Secondary Treatment for Men with Localized Prostate Cancer: a pooled analysis of PRIAS and ERSPC-Rotterdam data within the PIONEER data platform

Katharina Beyer* (Corresponding Author), Vera Straten, Sebastiaan Remmers, Steven MacLennan, Giorgio Gandaglia, Peter-Paul M. Willemse, Ronald Herrera, Muhammad Imran Omar, Beth Russell, Johannes Huber, Markus Kreuz, Alex Asiimwe, Tom Abbott, Alberto Briganti, Mieke Vanhemelrijck, Monique J Roobol, Sara MacLennan, The PRIAS Consortium, The ERSPC Rotterdam Study Group, The PIONEER Consortium

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


INTRODUCTION: Treatment choice for localized prostate cancer is complicated, as each treatment option comes with various pros and cons. It is well established that active surveillance (AS), may be ended with a change to curative treatment at the time of disease progression, but it is less clear whether secondary treatment after initial curative treatment is required. As part of the PIONEER project, we quantified the probabilities of treatment change.

METHODS: A cohort study based on PRIAS and ERSPC-Rotterdam data was conducted. Patients were followed up for 10 years or until the 31st of December 2017. The primary outcome was the incidence of treatment change following initial treatment (i.e., a change to curative treatment following AS or secondary treatment after initial RP/RT).

RESULTS: Over a period of 1 to 5 years after initial treatment, the cumulative incidence of treatment change ranged from 3.8% to 42.8% for AS, from 7.6% to 12.1% for radical prostatectomy (RP) and from no change to 5.3% for radiation therapy (RT). While the possibility of treatment change in AS is known, the numbers within a five-year period were substantial. For RP and RT, the rate of change to secondary treatment was lower, but still non-neglectable, with 5 (10)-year incidences up to 12% (20%) and 5% (16%), respectively.

CONCLUSION: This is one of the first studies comparing the incidence of guideline-recommended treatment changes in men receiving different primary treatments (i.e., AS, RT, or RP) for localized prostate cancer (PCa).

Original languageEnglish
Article number751
Number of pages8
JournalJournal of Personalized Medicine
Issue number5
Early online date5 May 2022
Publication statusPublished - 5 May 2022
EventEAU21 Virtual Congress - Virtual
Duration: 8 Jul 202112 Aug 2021


  • prostate cancer
  • active surveillance
  • treatment choice
  • patient decision-making
  • oncology
  • treatment selection


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