Clinical characteristics and quality-of-life in patients surviving a decade of prostate cancer with bone metastases
2016 (English)In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 117, no 6, 904-913 p.Article in journal (Refereed) PublishedText
Objective To describe characteristics and quality-of-life (QoL), and to define factors associated with long-term survival in a subgroup of patients with prostate cancer with M1b disease. Patients and Methods 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. Long-term survival was defined as patients having an overall survival of >= 10 years, and logistic regression models were constructed to identity clinical predictors of survival. QoL during follow-up was assessed using the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire - C30 version 1 (EORTC-C30) ratings. Results In all, 40 (4.4%) of the 915 men survived for >10 years. Factors significantly associated with increased likelihood of surviving for >10 years in the univariate analyses were: absence of cancer-related pain; Eastern Cooperative Oncology Group (ECOG) performance status of <2; negligible analgesic consumption; T-category of 1-2; prostate-specific antigen (PSA) level of <231 mu g/L; and a Soloway score of 1. In the multivariate analyses, ECOG performance status of <2, PSA level of <231 mu g/L, and Soloway score of 1, were all independent predictors of long-term survival. All subscales of the EORTC-C30 were higher in this group than for patients with short survival, but slowly declined over the decade. Conclusion A subgroup of patients with prostate cancer with M1b disease and certain characteristics showed a positive long-term response to androgen-deprivation therapy with an acceptable QoL over a decade or more. Independent predictors of long-term survival were identified as ECOG performance status of <2, limited extent of bone metastases (Soloway score of 1), and a PSA level of <231 mu g/L at the time of enrolment.
Place, publisher, year, edition, pages
WILEY-BLACKWELL , 2016. Vol. 117, no 6, 904-913 p.
prostate cancer; bone metastases; long-term survival; quality-of-life
IdentifiersURN: urn:nbn:se:liu:diva-128927DOI: 10.1111/bju.13190ISI: 000376009800015PubMedID: 26033416OAI: oai:DiVA.org:liu-128927DiVA: diva2:934980