{
  "abstract": "Purpose\n\nThe role of radical prostatectomy (RP) or radiotherapy (RT) in intermediate-risk prostate cancer (PCa) is still under debate. Our aim was to quantify the effect of RP and RT on the average years of life lost (YLL) in patients with intermediate-risk PCa.Methods\n\nWithin the SEER database 2004-2021, intermediate-risk PCa patients aged 45-75 were identified. Stratification rested on local therapy type: RP vs. RT vs. none. We performed Monte Carlo simulation to generate individual survival estimates based on Social Security Administration life tables. Subsequently, YLL was compared between PCa patients and matched population controls.Results\n\nOf 220,113 intermediate-risk PCa patients, 94,452 (42.9%), 85,232 (38.7%), and 40,429 (18.4%) underwent RP, RT, and no local therapy, respectively. Compared to population controls, RP and RT patients did not exhibit YLL disadvantages. Conversely, no local therapy patients exhibited a survival disadvantage of 0.21 YLL (p < 0.001). In the subgroup of patients diagnosed at age 45-55, a YLL disadvantage was seen for no local therapy (1.32) and RT patients (0.69), while their RP counterparts did not exhibit a YLL disadvantage. In further subgroup analyses, a substantial YLL disadvantage was recorded in unfavorable intermediate-risk PCa patients without local therapy (0.47 YLL), whereas no YLL disadvantage was seen in unfavorable intermediate-risk PCa patients who underwent RP or RT.Conclusion\n\nIn intermediate-risk PCa, no YLL disadvantage was observed in RP and RT patients within all subgroups. Patients diagnosed at a young age and with unfavorable cancer characteristics are at increased risk for premature death if not locally treated.Trial registration\n\ndoi10.17605 OSF.IO/D2RUV.",
  "abstract_shown": true,
  "affiliations": [
    "Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada. falkenbach@me.com.",
    "Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. falkenbach@me.com.",
    "Department of Urology, University Hospital Heidelberg, Heidelberg, Germany. falkenbach@me.com.",
    "Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada.",
    "Vita-Salute San Raffaele University, Milan, Italy.",
    "Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.",
    "Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, Milan, Italy.",
    "Department of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany.",
    "Department of Urology, University of Bologna, St. Orsola-Malpighi Hospital, Bologna, Italy.",
    "Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy.",
    "Division of Urology, Department of Oncology, University of Turin, Orbassano, Italy.",
    "Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy.",
    "Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.",
    "Department of Urology, Weill Cornell Medical College, New York, NY, USA.",
    "Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.",
    "Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan.",
    "Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.",
    "Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 18,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Fabian Falkenbach",
      "orcid": "0000-0003-1907-3982"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Mattia Longoni"
    },
    {
      "affs": [
        3,
        5,
        6
      ],
      "name": "Andrea Marmiroli"
    },
    {
      "affs": [
        3,
        7
      ],
      "name": "Quynh Chi Le"
    },
    {
      "affs": [
        3,
        8
      ],
      "name": "Calogero Catanzaro"
    },
    {
      "affs": [
        3,
        9,
        10
      ],
      "name": "Michele Nicolazzini"
    },
    {
      "affs": [
        3,
        11
      ],
      "name": "Federico Polverino"
    },
    {
      "affs": [
        3
      ],
      "name": "Jordan A Goyal"
    },
    {
      "affs": [
        8
      ],
      "name": "Riccardo Schiavina"
    },
    {
      "affs": [
        9
      ],
      "name": "Carlotta Palumbo"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Gennaro Musi"
    },
    {
      "affs": [
        7
      ],
      "name": "Felix K H Chun"
    },
    {
      "affs": [
        4
      ],
      "name": "Alberto Briganti"
    },
    {
      "affs": [
        3
      ],
      "name": "Fred Saad"
    },
    {
      "affs": [
        12,
        13,
        14,
        15
      ],
      "name": "Shahrokh F Shariat"
    },
    {
      "affs": [
        16,
        17
      ],
      "name": "Lars Budäus"
    },
    {
      "affs": [
        16
      ],
      "name": "Markus Graefen"
    },
    {
      "affs": [
        3
      ],
      "name": "Pierre I Karakiewicz"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/54jty0rghfrmb.bib",
  "cited_by": 0,
  "doi": "10.1007/s00345-026-06858-4",
  "fulltext_url": "https://europepmc.org/articles/PMC13722718",
  "id": "54jty0rghfrmb",
  "issns": [
    "0724-4983",
    "1433-8726"
  ],
  "landing_url": "https://europepmc.org/article/MED/42961521",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2740|Prostate Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7224826563",
  "pdf_url": "https://europepmc.org/articles/PMC13722718?pdf=render",
  "pmcid": "PMC13722718",
  "pmid": "42961521",
  "published": "2026-10-30",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/54jty0rghfrmb.ris",
  "sources": [
    {
      "first_seen": "2026-11-02T03:21:21Z",
      "native_id": "MED:42961521",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42961521"
    },
    {
      "first_seen": "2026-11-04T12:21:29Z",
      "native_id": "PMC13722718",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s00345-026-06858-4"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Prostate Cancer Diagnosis and Treatment",
      "subfield": "general"
    }
  ],
  "title": "Local treatment vs. years of life lost in intermediate-risk prostate cancer.",
  "title_text": "Local treatment vs. years of life lost in intermediate-risk prostate cancer.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-04T12:21:29Z",
  "url": "https://research.draconitic.com/paper/54jty0rghfrmb",
  "venue": "World journal of urology",
  "versions": []
}