OBJECTIVE: To describe characteristics and quality-of-life (QOL) and to define factors associated with long-term survival in a subgroup of prostate cancer patients with M1b disease.
METHODS AND PATIENTS: The study was based on 915 patients from a prospective randomised multicentre trial (no.5) by the Scandinavian Prostate Cancer Group, comparing parenteral oestrogen with total androgen blockade (TAB). Long-term survival was defined as patients having an overall survival >10 year, and logistic regression models were constructed to identity clinical predictors of survival. QOL during follow-up was assessed using EROTC-30 ratings.
RESULTS: Forty (4.4%) of the 915 men survived longer than 10 years. Factors significantly associated with increased likelihood of surviving more than ten years in the univariate analyses were: absence of cancer-related pain; performance status < 2; negligible analgesic consumption; T-category 1-2; PSA < 231 μg/L; and a Soloway score 1. In the multivariate analyses, performance status < 2, PSA < 231 μg/L, and Soloway score 1, were all independent predictors of long-term survival. All subscales of EORTC-C30 were higher in this group than for patients with short survival, but slowly declined over the decade.
CONCLUSION: A subgroup of prostate cancer patients with M1b disease and certain characteristics showed a positive long-term response to ADT with an acceptable QOL over a decade or more. Independent predictors of long-term survival were identified as performance status < 2, limited extent of bone metastases (Soloway score 1), and a PSA level < 231 μg/L at the time of enrolment.
Klaff R, Berglund A, Varenhorst E, Hedlund PO, Jǿnler M, Sandblom G. Are you the author?
Department of Urology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Eksätravägen 72, Uppsala, Sweden; Department of Urology, Karolinska Institute Solna, Sweden; Department of Urology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Hospital Huddinge, Sweden.
Reference: BJU Int. 2015 Jun 1. Epub ahead of print.