Objective: This study aims to (1) characterise men diagnosed with metastatic prostate cancer, (2) describe their management and (3) look at their survival.
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Methods: We identified patients registered with prostate cancer in the New Zealand Cancer Registry in the Midland Cancer Network region in 2009-2012 and examined these patients' clinical records to identify the metastatic cases. We investigated the patients' characteristics and the treatment pattern. All-cause survival was estimated by the Cox proportional hazards model.
Results: Of the 2,127 men diagnosed with prostate cancer, 234 (26 Maori/Pacific and 208 non-Maori/non-Pacific) were diagnosed with metastatic prostate cancer. After the diagnosis, 194 (82.9%) patients received androgen deprivation therapy (ADT), 5 had chemotherapy and 104 (44.4%) had radiotherapy. Of the patients treated with ADT, 46 (23.7%) had no monitoring prostate-specific antigen tests. Fifty-nine percent of the patients were alive after 12 months and 35% after 24 months. The hazard ratio for the Maori/Pacific men was 1.49.
Conclusion: Overall, the survival of patients with metastatic prostate cancer was poor. There seems to be a strong case for the development of New Zealand guidelines on the management of metastatic disease including the use of first-line treatments, the ongoing monitoring for the development of castration-resistant prostate cancer (CRPC) and the treatment of CRPC.
Lawrenson R, Lao C, Obertová Z, Brown C, Holmes M, Tyrie L, Scott N, Fong P, Laking G. Are you the author?
Waikato Clinical Campus, The University of Auckland, Hamilton, New Zealand.
Reference: Oncology. 2014 Nov 15;88(3):157-163.