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Impact of treatment on progression to castration‐resistance, metastases, and death in men with localized high‐grade prostate cancer
Men with high‐grade prostate cancer (HGPC) are at greatest risk of disease progression. Clinical risk factors associated with castration‐resistant prostate cancer (CRPC), metastases, and prostate cancer‐specific mortality (PCSM) were identified in a contemporary HGPC cohort. Clinical data was collec...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5269571/ https://www.ncbi.nlm.nih.gov/pubmed/27997745 http://dx.doi.org/10.1002/cam4.981 |
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author | Miller, Eric T. Chamie, Karim Kwan, Lorna Lewis, Michael S. Knudsen, Beatrice S. Garraway, Isla P. |
author_facet | Miller, Eric T. Chamie, Karim Kwan, Lorna Lewis, Michael S. Knudsen, Beatrice S. Garraway, Isla P. |
author_sort | Miller, Eric T. |
collection | PubMed |
description | Men with high‐grade prostate cancer (HGPC) are at greatest risk of disease progression. Clinical risk factors associated with castration‐resistant prostate cancer (CRPC), metastases, and prostate cancer‐specific mortality (PCSM) were identified in a contemporary HGPC cohort. Clinical data was collected from men diagnosed with Gleason sum (GS) ≥8 at the Greater Los Angeles Veterans Affairs (GLA‐VA) Healthcare System between 2000 and 2013. Multivariable competing risks regression analyses assessed progression to CRPC, metastases, and PCSM within three treatment strata. The cumulative incidence of disease progression was calculated at 2, 5, and 10‐year time points. Review of 2149 prostate cancer cases yielded 322 with HGPC. Median survival times for cancer‐specific and overall mortality were significantly shorter in men treated with primary androgen deprivation therapy (ADT) (P = 0.0002 and P < 0.0001). Multivariable analyses revealed that clinical stage N1, GS 10, and treatment with primary ADT were significantly associated with increased risk of CRPC, metastases, and PCSM. Significant differences in these outcomes were not observed in men treated with radical prostatectomy (RP) when compared to those treated with radiation therapy combined with short‐term ADT (XRT‐ADT). Ten‐year event rates of progression to CRPC, metastases, and PCSM, for men treated with primary ADT, were 45.5%, 25.4%, and 25.1%, respectively. In conclusion, GS 10 and lymph node involvement, as well as primary ADT treatment in men with HGPC was associated with increased risk of CRPC, metastases, and PCSM. Curative‐intent treatment with RP or XRT‐ADT is associated with reduced progression rates and death in men with HGPC. |
format | Online Article Text |
id | pubmed-5269571 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-52695712017-02-01 Impact of treatment on progression to castration‐resistance, metastases, and death in men with localized high‐grade prostate cancer Miller, Eric T. Chamie, Karim Kwan, Lorna Lewis, Michael S. Knudsen, Beatrice S. Garraway, Isla P. Cancer Med Clinical Cancer Research Men with high‐grade prostate cancer (HGPC) are at greatest risk of disease progression. Clinical risk factors associated with castration‐resistant prostate cancer (CRPC), metastases, and prostate cancer‐specific mortality (PCSM) were identified in a contemporary HGPC cohort. Clinical data was collected from men diagnosed with Gleason sum (GS) ≥8 at the Greater Los Angeles Veterans Affairs (GLA‐VA) Healthcare System between 2000 and 2013. Multivariable competing risks regression analyses assessed progression to CRPC, metastases, and PCSM within three treatment strata. The cumulative incidence of disease progression was calculated at 2, 5, and 10‐year time points. Review of 2149 prostate cancer cases yielded 322 with HGPC. Median survival times for cancer‐specific and overall mortality were significantly shorter in men treated with primary androgen deprivation therapy (ADT) (P = 0.0002 and P < 0.0001). Multivariable analyses revealed that clinical stage N1, GS 10, and treatment with primary ADT were significantly associated with increased risk of CRPC, metastases, and PCSM. Significant differences in these outcomes were not observed in men treated with radical prostatectomy (RP) when compared to those treated with radiation therapy combined with short‐term ADT (XRT‐ADT). Ten‐year event rates of progression to CRPC, metastases, and PCSM, for men treated with primary ADT, were 45.5%, 25.4%, and 25.1%, respectively. In conclusion, GS 10 and lymph node involvement, as well as primary ADT treatment in men with HGPC was associated with increased risk of CRPC, metastases, and PCSM. Curative‐intent treatment with RP or XRT‐ADT is associated with reduced progression rates and death in men with HGPC. John Wiley and Sons Inc. 2016-12-20 /pmc/articles/PMC5269571/ /pubmed/27997745 http://dx.doi.org/10.1002/cam4.981 Text en © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Cancer Research Miller, Eric T. Chamie, Karim Kwan, Lorna Lewis, Michael S. Knudsen, Beatrice S. Garraway, Isla P. Impact of treatment on progression to castration‐resistance, metastases, and death in men with localized high‐grade prostate cancer |
title | Impact of treatment on progression to castration‐resistance, metastases, and death in men with localized high‐grade prostate cancer |
title_full | Impact of treatment on progression to castration‐resistance, metastases, and death in men with localized high‐grade prostate cancer |
title_fullStr | Impact of treatment on progression to castration‐resistance, metastases, and death in men with localized high‐grade prostate cancer |
title_full_unstemmed | Impact of treatment on progression to castration‐resistance, metastases, and death in men with localized high‐grade prostate cancer |
title_short | Impact of treatment on progression to castration‐resistance, metastases, and death in men with localized high‐grade prostate cancer |
title_sort | impact of treatment on progression to castration‐resistance, metastases, and death in men with localized high‐grade prostate cancer |
topic | Clinical Cancer Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5269571/ https://www.ncbi.nlm.nih.gov/pubmed/27997745 http://dx.doi.org/10.1002/cam4.981 |
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