br In age adjusted analyses that were further stratified

134 In age-adjusted analyses that were further stratified according to ethnicity, African-American
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140 In age-adjusted analyses that were further stratified according to marital status, unmarried
145 Conversely, in age-adjusted analyses that were further stratified according to SES, no
146 meaningful difference was recorded in 5-year OCM rates over time, as well as in annual
150 Multivariable analyses
151 In multivariable Cox regression models, year of diagnosis represented an independent
155 category represented an independent predictor of lower OCM. Specifically, HR of 0.64, 0.44,
159 compared to African-American men. Additionally, married status also represented an
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161 Discussion
162 Since life expectancy is on steady rise in most developed countries, a decrease in OCM would
163 also be expected in PCa patients (7). However, only one European institutional analysis
164 examined OCM in clinically localized PCa patients treated with RP (8). Unfortunately, no
165 EBRT patients were assessed. Moreover, to the best of our knowledge, no North-American
166 population-based analysis reported on OCM rates in clinically localized PCa patients treated
167 with RP or EBRT. Based on this Vaborbactam void, we examined the time trends of OCM rates in clinically
168 localized PCa patients. We hypothesized that OCM rates decreased in more contemporary
169 patients relative to their more historical counterparts. We also postulated that the decrease
170 might be stronger in older than in younger patients. Our analyses yielded several noteworthy
173 significant and clinically meaningful fashion. The decrease was recorded in the overall cohort
176 pronounced decrease was recorded in EBRT (slope: -0.29%/year) compared to RP patients
178 represented the double of the value recorded in RP patients, even with age adjustment. In
179 consequence, contemporary EBRT patients still represent very important targets for
180 improving patient selection based on OCM considerations, even when the general selection of
181 patients with respect to the competing effect of OCM improved over the past 25 years in a
182 highly meaningful fashion. To the best of our knowledge, we are the first to demonstrate this
183 phenomenon in a large North-American cohort of patients. A smaller scale institutional
184 European study showed the same phenomenon exhibiting a decrease in OCM rates over time
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186 Second, we identified important differences in the magnitude of OCM reduction over time
187 according to patient age. Specifically, the most pronounced OCM reduction over time was
188 recorded in oldest patients (≥75 years). Conversely, a much lower albeit non-zero percent
189 reduction was recorded in the youngest patients. These observations indicate that the prime
190 targets for improving patient selection criteria for definitive therapy are the oldest and older
191 patients. Nonetheless, potential benefits in OCM rate reduction may even be expected in
192 younger individuals. However, the absolute rate of OCM decrease in the youngest category of
194 translate into meaningful differences in nationwide initiatives, but may not be detectable at
195 institutional level.
196 Third, important differences in OCM were also recorded according to ethnicity. Highest
197 baseline 5-year OCM rate was recorded in African-American patients (11%), followed by
199 decreased in all three ethnic groups over time. The most significant decrease was recorded in
202 particularly important, since recently Dess et al. reported that after adjustment for non-