Initial Treatment Patterns And Outcome Of Contemporary Prostate Cancer Patients With Bone Metastases At Initial Presentation

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Men's health;  Clinical Trials / Drug Trials
Article Date: 03 Jun 2007 - 0:00 PDT

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UroToday.com- In an online published article of the journal Cancer, Dr. Charles Ryan and associates reported on the practice patterns and outcomes of patients initially presenting with bone metastasis from prostate cancer (CaP).

CaPSURE, the observational disease registry of men with CaP was used to do the study. Information regarding comorbidities was collected from a self-administered questionnaire by participants at the time of enrollment. Patients were defined as having bone metastasis if any of the following criteria were met; physicians' report of bone metastasis, a positive bone scan, radiotherapy to a bone met or other physician assessment indicating bone metastasis.

From the years 1990-2003, 10,186 men were enrolled in CaPSURE and 277 met the criteria for stage M1b disease and had sufficient follow-up. Treatment within the first 6 months of diagnosis included hormonal therapy of any type in 84% (LHRH agonist in 73%, an antiandrogen in 56% and orchiectomy in 12%). Seven percent received no therapy during the first 6 months after diagnosis and some form of local therapy was given to 17% within the first 6 months. The percent of patients receiving only non-hormonal therapy decreased from 22% during 1990-1992 to 6% during 2001-2003. Patients diagnosed during the later registry years were more likely to receive androgen deprivation therapy.

With a median follow-up of 3.8 years, 107 patients (39%) had died and of these 68 died of CaP and 39 died of other causes. Variables associated with all-cause mortality were comorbid illness, Gleason score >7 and increased body mass index. Variables associated with CaP specific mortality were younger age at diagnosis (HR 0.47 for age >65 years), presented comorbidities, and a biopsy Gleason score of >7. The type of treatment was not associated with survival in these men.

Ryan CJ, Elkin EP, Cowan J, Carroll PR

Cancer. Epub, May 21 2007
doi: 0.1002/cncr.22736

Reported by UroToday.com Contributing Editor Christopher P. Evans, M.D.

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