ORLANDO, FL, USA (UroToday.com) - In a PSA-screened population, less than 5% of men presented with de novo metastatic prostate cancer.
This database analysis looked to distinguish the clinical characteristics and survival of this group of men by a retrospective analysis of an institutional database at Dana Farber Cancer Institute called Prostate Clinical Research Information Systems (CRIS). All men with metastatic disease as their first presentation of prostate cancer were identified, and the patient and disease characteristics were summarized descriptively.
There were 185 patients in the analytic cohort with a median follow-up of 7.8 years; 94% of them were diagnosed after 1998. The median age at diagnosis was 62 years (Range: 42-86) and PSA at diagnosis: Median (Q1-Q3) - 100.2 ng/ml (Range: 23.0, 346.0). Metastases were diagnosed at the following rate: 97% bone, 2% liver, 2% lung, 8% lymph node. The median time from diagnosis of metastases to start of androgen deprivation therapy (ADT) was 26 days and 139 of those men who started ADT had subsequently started treatment for castration-resistant prostate cancer (CRPC), i.e. second line hormonal therapy and/or chemotherapy. The median time from ADT to subsequent therapy for CRPC was 14 months. Median overall survival (OS) was 48 months and 128 patients have died.
To conclude, this database analysis showed that the unique cohort of patients who presented with de novo metastatic prostate cancer at a referral institution tended to be younger and had an OS comparable to outcomes in randomized hormone-sensitive prostate cancer studies. To confirm this observation, assessment of a similar group of men in a multivariate analysis of a prospective trial is needed. If confirmed, the data would suggest the responsiveness to therapy drives outcome rather than development of metastasis, with or without a previously treated primary.
Presented by Jessica Strock, Kathryn P. Gray, Mari Nakabayashi, Carolyn Evan, Elizabeth O’Donnell, Mark Pomerantz, Philip W. Kantoff, and Christopher Sweeney at the 2013 Genitourinary Cancers Symposium - February 14 - 16, 2013 - Rosen Shingle Creek - Orlando, Florida USA
Dana-Farber Cancer Institute, Boston, MA
Written by Anna Forsberg, medical reporter for UroToday.com
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