Contemporary prostate cancer survival in Ireland: a national benchmark analysis using IPCOR data

Background

Prostate cancer (PCa) is the most commonly diagnosed cancer among men in Ireland, with over 4,000 new cases annually. Population-based survival estimates are needed to benchmark outcomes and inform service planning in the modern diagnostic and treatment era. The Irish Prostate Cancer Outcomes Research (IPCOR) registry is a national multicentre cohort capturing clinical data across public and private hospitals. Long-term survival outcomes in this cohort have not been comprehensively reported. While survival is high, outcomes remain heterogeneous, highlighting the need for subgroup analysis. The aim was to estimate overall survival (OS) and examine variation by risk, treatment, and socioeconomic status.

Methods

IPCOR data were linked to the National Cancer Registry Ireland survival update. OS was estimated using Kaplan–Meier methods and compared using log-rank tests. Multivariable Cox regression identified predictors of mortality, adjusting for age, CAPRA risk group, primary treatment, and deprivation index.

Results

Among 6816 men, median follow-up was 103 months (IQR 94-112). Five- and ten-year OS rates were 89.6% and 79.5%. Survival differed by CAPRA risk (p < 0.001), with 5-year OS of 97.6%, 95%, and 80% for low, intermediate, and high risk. Survival also varied by treatment (p < 0.001), highest with radical prostatectomy (RP) (97.5%) and lowest with androgen deprivation therapy (62.2%). No differences were observed by deprivation (p = 0.35). In adjusted analyses, intermediate- and high-risk disease (HR 1.78, 95% CI 1.38-2.29 and HR 4.25, 95% CI 3.29-5.49), RP (HR 0.30, 95% CI 0.23-0.40) and radiotherapy (HR 0.54, 95% CI 0.44-0.64) vs active surveillance, and age (HR 1.07, 95% CI 1.06-1.08), were associated with mortality.

Conclusions

This study provides a national benchmark of contemporary PCa survival in Ireland. Variation by risk and treatment highlights opportunities to enhance quality of care through optimising treatment selection and care pathways.

Key messages

• This study provides the first contemporary national benchmark of prostate cancer survival in Ireland, supporting monitoring of outcomes and informing service planning.

• Variation in survival by risk and treatment highlights opportunities to optimise treatment selection and enhance prostate cancer care in Ireland.