Time of metastatic disease presentation and volume of disease are prognostic for metastatic hormone sensitive prostate cancer (mHSPC)

Background Currently, there is no universally accepted prognostic classification for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC) treated with androgen deprivation therapy (ADT). Subgroup analyses demonstrated that pts with low volume (LV), per CHAARTED trial definition,...

Celý popis

Uloženo v:
Podrobná bibliografie
Vydáno v:The Prostate Ročník 78; číslo 12; s. 889 - 895
Hlavní autoři: Francini, Edoardo, Gray, Kathryn P., Xie, Wanling, Shaw, Grace K., Valença, Loana, Bernard, Brandon, Albiges, Laurence, Harshman, Lauren C., Kantoff, Philip W., Taplin, Mary‐Ellen, Sweeney, Cristopher J.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Wiley Subscription Services, Inc 01.09.2018
Témata:
ADT
Aged
Androgen Antagonists - administration & dosage
Androgen Antagonists - therapeutic use
Antineoplastic Agents
Castration
Classification
Docetaxel - therapeutic use
Humans
Male
Medical prognosis
Metastases
Metastasis
mHSPC
Middle Aged
Neoplasm Metastasis - pathology
Pain
Prognosis
prognostic classification
Proportional Hazards Models
Prostate cancer
Prostate-Specific Antigen - analysis
Prostatic Neoplasms - mortality
Prostatic Neoplasms - pathology
Prostatic Neoplasms - therapy
Prostatic Neoplasms, Castration-Resistant
Registries
Retrospective Studies
Survival Rate
Time Factors
time of metastatic disease
volume of disease
volume of disease
ADT
prognostic classification
mHSPC
time of metastatic disease
ISSN:0270-4137, 1097-0045, 1097-0045
On-line přístup:Získat plný text
Tagy: Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
Popis
Shrnutí:Background Currently, there is no universally accepted prognostic classification for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC) treated with androgen deprivation therapy (ADT). Subgroup analyses demonstrated that pts with low volume (LV), per CHAARTED trial definition, mHSPC, and those who relapse after prior local therapy (PLT) have longer overall survival (OS) compared to high volume (HV) and de‐novo (DN), respectively. Using a hospital‐based registry, we aimed to assess whether a classification based on time of metastatic disease (PLT vs DN) and disease volume (LV vs HV) are prognostic for mHSPC pts treated with ADT. Methods A retrospective cohort of consecutive patients with mHSPC treated with ADT between 1990 and 2013 was selected from the prospectively collected Dana‐Farber Cancer Institute database and categorized as DN or PLT and HV or LV, at time of ADT start. Primary and secondary endpoints were OS and time to castration‐resistant prostate cancer (CRPC), respectively, which were measured from date of ADT start using Kaplan‐Meier method. Multivariable Cox proportional hazards models using known prognostic factors was used. Results The analytical cohort consisted of 436 patients. The median OS and time to CRPC for PLT/LV were 92.4 (95%CI: 80.4‐127.2) and 25.6 (95%CI: 21‐35.7) months and 43.2 (95%CI: 37.2‐56.4) and 12.2 (95%CI: 9.8‐14.8) months for DN/HV, respectively, whereas intermediate values were observed for PLT/HV and DN/LV. A robust gradient for both outcomes was observed (Trend test P < 0.0001) in the four groups. In a multivariable analysis, DN presentation, HV, and cancer‐related pain were independent prognostic factors. Conclusions In our hospital‐based registry, time of metastatic presentation and disease volume were prognostic for mHSPC pts treated with ADT. This simple prognostic classification system can aid patient counseling and future trial design.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
ISSN:0270-4137
1097-0045
1097-0045
DOI:10.1002/pros.23645