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Clin Genitourin Cancer. 2017 Feb;15(1):60-66.e2. doi: 10.1016/j.clgc.2016.08.018. Epub 2016 Aug 31.

Predicting Time From Metastasis to Overall Survival in Castration-Resistant Prostate Cancer: Results From SEARCH.

Author information

1
Department of Urology, University of Illinois at Chicago, Chicago, IL. Electronic address: moreira@uic.edu.
2
Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC; Urology Section, Veterans Affairs Medical Center, Durham, NC; Division of Urology, Department of Surgery, and the Duke Prostate Center, Duke University School of Medicine, Durham, NC.
3
Urology Section, Veterans Affairs Medical Center, Durham, NC; Division of Urology, Department of Surgery, and the Duke Prostate Center, Duke University School of Medicine, Durham, NC.
4
Urology Section, Department of Surgery, Veterans Affairs Medical Center, Greater Los Angeles, Los Angeles, CA; Department of Urology, University of California at Los Angeles Medical Center, Los Angeles, CA.
5
Division of Urology, Department of Surgery, University of California at San Diego Medical Center, San Diego, CA.
6
Urology Section, Division of Surgery, Veterans Affairs Medical Centers and Division of Urologic Surgery, Department of Surgery, Medical College of Georgia, Augusta, GA.
7
Division of Urology, Department of Surgery, Oregon Health and Science University, Portland, OR.
8
Departments of Urology and Epidemiology and Biostatistics, University of California, San Francisco and Urology Section, Department of Surgery, Veterans Affairs Medical Center, San Francisco, CA.
9
Urology Section, Veterans Affairs Medical Center, Durham, NC; Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.

Abstract

OBJECTIVE:

To identify the predictors of time from initial diagnosis of metastatic castration-resistance prostate cancer (mCRPC) to all-cause death within the Shared Equal Access Regional Cancer Hospital cohort.

PATIENTS AND METHODS:

We performed a retrospective analysis of 205 mCRPC men. Overall survival was estimated and plotted using the Kaplan-Meier method. The uni- and multivariable overall survival predictors were evaluated with the Cox proportional hazards model. A nomogram was generated to predict overall survival at 1, 2, 3, and 5 years after mCRPC. Concordance index and calibration plot were obtained.

RESULTS:

A total of 170 men (83%) died over a median follow-up of 41 months. In univariable analysis, older age, more remote year of mCRPC, nonblack race, greater number of bone metastasis, higher prostate-specific antigen (PSA) levels, shorter PSA doubling time, and faster PSA velocity at mCRPC diagnosis were significantly associated with shorter overall survival (all P < .05). In multivariable analysis, older age, more remote year of mCRPC, greater number of bone metastasis, higher PSA levels, and shorter PSA doubling time at mCRPC diagnosis remained significantly associated with shorter overall survival (all P < .05). On the basis of these variables, a nomogram was generated yielding a concordance index of 0.67 and good calibration.

CONCLUSION:

The use of clinical parameter such as age, disease burden, and PSA levels and kinetics can be used to estimate overall survival in mCRPC patients.

KEYWORDS:

Disease-free survival; Mortality; Prostate cancer; Prostate-specific antigen; Prostatectomy

PMID:
27692812
PMCID:
PMC5536956
DOI:
10.1016/j.clgc.2016.08.018
[Indexed for MEDLINE]
Free PMC Article

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