OBJECTIVES: To examine the incidence of metastases and clinical course of prostate cancer patients who are without confirmed metastasis when initiating androgen deprivation therapy (ADT).
METHODS: Retrospective cohort study conducted using electronic medical records from Swedish outpatient urology clinics linked to national mandatory registries to capture medical and demographic data. Prostate cancer patients initiating ADT between 2000 and 2010 were followed from initiation of ADT to metastasis, death, and/or end of follow-up.
RESULTS: The 5-year cumulative incidence (CI) of metastasis was 18%. Survival was 60% after 5 years; results were similar for bone metastasis-free survival. The 5-year CI of castration-resistant prostate cancer (CRPC) was 50% and the median survival from CRPC development was 2.7 years. Serum prostate-specific antigen (PSA) levels and PSA doubling time were strong predictors of bone metastasis, any metastasis, and death.
CONCLUSION: This study provides understanding of the clinical course of prostate cancer patients without confirmed metastasis treated with ADT in Sweden. Greater PSA values and shorter PSA doubling time (particularly≤ 6 months) were associated with increased risk of bone metastasis, any metastasis, and death.
Written by:
Banefelt J, Liede A, Mesterton J, Stålhammar J, Hernandez RK, Sobocki P, Persson BE. Are you the author?
Quantify Research, Hantverkargatan 8, 112 21 Stockholm, Sweden; Amgen Inc., Center for Observational Research, South San Francisco, CA, United States; Quantify Research, Hantverkargatan 8, 112 21 Stockholm, Sweden; Institute of Environmental Medicine, Karolinska Institute, 171 77 Stockholm, Sweden; Department of Public Health and Caring Sciences, Uppsala University, 751 22 Uppsala, Sweden; Amgen Inc., Center for Observational Research, One Amgen Center Drive 24-2-A, Thousand Oaks, CA 91320, United States; IMS Health/Pygargus, Sveavägen 155, 113 46 Stockholm, Sweden; LIME/Medical Management Centre, Karolinska Institute, 171 77 Stockholm, Sweden; Uppsala University, 751 05 Uppsala, Sweden.
Reference: Cancer Epidemiol. 2014 May 26. pii: S1877-7821(14)00089-7.
doi: 10.1016/j.canep.2014.04.007
PubMed Abstract
PMID: 24875326
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