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

UroToday.com Prostate Cancer Section

Written by Christopher P. Evans, MD, a Contributing Editor with UroToday.

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