Validation of the Social Security Administration Life Tables (2004–2014) in Localized Prostate Cancer Patients within the Surveillance, Epidemiology, and End Results database

Backround: Accurate life expectancy estimation is crucial in clinical decision-making including management and treatment of clinically localized prostate cancer (PCa). Objective: We hypothesized that Social Security Administration (SSA) life tables’ derived survival estimates closely follow observed survival of PCa patients. To test this relationship, we examined 10-yr overall survival rates in patients with clinically localized PCa and compared it with survival estimates derived from the SSA life tables. Patients and methods: Within the Surveillance, Epidemiology, and End Results database (2004), we identified patients aged >50– < 90 yr. Follow-up was at least 10 yr for patients who did not die of disease or other causes. Outcome measurements and statistical analysis: Monte Carlo method was used to define individual survival in years, according to the SSA life tables (2004–2014). Subsequently, SSA life tables’ predicted survival was compared with observed survival rates in Kaplan-Meier analyses. Subgroup analyses were stratified according to treatment type and D'Amico risk classification. Results and limitations: Overall, 39 191 patients with localized PCa were identified. At 10-yr follow-up, the SSA life tables’ predicted survival was 69.5% versus 73.1% according to the observed rate (p < 0.0001). The largest differences between estimated versus observed survival rates were recorded for D'Amico low-risk PCa (8.0%), brachytherapy (9.1%), and radical prostatectomy (8.6%) patients. Conversely, the smallest differences were recorded for external beam radiotherapy (1.7%) and unknown treatment type (1.6%) patients. Conclusions: Overall, SSA life tables’ predicted life expectancy closely approximate observed overall survival rates. However, SSA life tables’ predicted rates underestimate by as much as 9.1% the survival in brachytherapy patients, as well as in D'Amico low-risk and radical prostatectomy patients. In these patient categories, an adjustment for the degree of underestimation might be required when counseling is provided in clinical practice. Patient summary: Social Security Administration (SSA) life tables’ predicted life expectancy closely approximate observed overall survival rates. However, SSA life tables’ predicted rates underestimate by as much as 9.1% the survival in brachytherapy patients, as well as in D'Amico low-risk and radical prostatectomy patients. Social Security Administration life tables’ predicted life expectancy closely approximate observed survival rates. However, life tables’ predicted rates underestimate by as much as 9.1% the overall survival in brachytherapy patients as well as in D'Amico low-risk and radical prostatectomy patients.