Characterizations of Clinical and Therapeutic Histories for Men With Prostate Cancer-Specific Mortality.

Careful descriptions of men with prostate cancer (PCa)-specific mortality are scant in nontrial settings. The present retrospective review describes the clinical characteristics, timelines, and treatment histories from initial presentation to death in a cohort of men with metastatic, castrate-resistant PCa (mCRPC).

Unique to the present study is the unequivocal attribution of PCa death by a single experienced clinician.

A total of 119 patients who had been treated at Tulane Cancer Center and had died of mCRPC from 2008 to 2015 were studied through a retrospective review of the medical records.

The median age at diagnosis was 65 years (range, 40-85 years), and 34. 4% of the patients presented with metastatic disease (stage M1). Of these patients, 56% had received definitive primary therapy, all had received androgen-deprivation therapy, and 52% had received docetaxel. The patients had received a median of 7 (1-14) systemic therapies before death. Most were secondary hormonal manipulations after the diagnosis of mCRPC (median, 4; range, 0-9). The median survival was 69 months (range, 5-270 months) after diagnosis, and the median age at death was 73 years (range, 47-95 years). The presence of metastases at diagnosis was a significant predictor of early death (hazard ratio, 4. 33; P < . 001), and definitive primary therapy was a significant predictor of longer survival (P < . 001). The median survival for patients presenting with metastases was 39 months (range, 5-235 months) compared with 100 months (range, 6-270 months) for those with localized disease (P < . 001). The median age at diagnosis between the docetaxel- and non-docetaxel-treated patients was significantly different at 62 and 71 years, respectively (P = . 002).

The present retrospective analysis provides initial views clarifying the clinical characteristics of men dying of mCRPC and the therapies they received before death. Additional data are needed in multi-institutional settings to confirm these findings.

Clinical genitourinary cancer. 2015 Nov 11 [Epub ahead of print]

Allie E Steinberger, Elisa M Ledet, Eric Luk, Patrick Cotogno, Michael Stolten, Daniel Desmond, Allison Feibus, Jonathan Silberstein, Oliver Sartor

Tulane University School of Medicine, New Orleans, LA. , Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA. , Department of Internal Medicine, University of Massachusetts Medical School, Worcester, MA. , Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA. , Tulane University School of Medicine, New Orleans, LA. , Tulane University School of Medicine, New Orleans, LA. , Department of Urology, Tulane University School of Medicine, New Orleans, LA. , Department of Urology, Tulane University School of Medicine, New Orleans, LA. , Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA; Departments of Medicine and Urology, Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA. 

PubMed