scholarly journals Improvement in overall and cancer‐specific survival in contemporary, metastatic prostate cancer chemotherapy exposed patients

The Prostate ◽  
2021 ◽  
Author(s):  
Benedikt Hoeh ◽  
Christoph Würnschimmel ◽  
Rocco S. Flammia ◽  
Benedikt Horlemann ◽  
Gabriele Sorce ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Chemotherapy ◽  
Metastatic Prostate Cancer ◽  
Cancer Specific Survival

A novel artificial intelligence biomarker: Validation of the automated bone scan index (aBSI) in veterans with metastatic prostate cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17507-e17507
Author(s):  
Vipal P. Durkal ◽  
Nicholas George Nickols ◽  
Matthew Rettig
Keyword(s):  
Prostate Cancer ◽  
Artificial Intelligence ◽  
Overall Survival ◽  
Bone Scan ◽  
Metastatic Prostate Cancer ◽  
Unmet Need ◽  
Bone Scan Index ◽  
Cancer Specific Survival ◽  
Cancer Specific Mortality ◽  
Bone Scans

e17507 Background: Prostate cancer commonly metastasizes to the bone and is associated with reduced survival, pathologic fractures and bone pain. The assessment of bone lesions is made with the technetium Tc99m(99mTc) bone scan, which relies on the subjective interpretation of radiologists and has a wide interobserver variability. There is an unmet need for a more objective and quantifiable measurement tool. Progenics Pharmaceuticals has introduced an automated bone scan index (aBSI), which employs artificial intelligence to quantify skeletal tumor burden. The automated bone scan index has been prospectively validated and is reproducible in large Phase III studies. The aBSI was validated by our study in the Veteran population at the West LA VA Medical Center. Methods: The first positive technetium 99 Tc99m bone scans of veterans diagnosed with metastatic, castration-sensitive prostate cancer were evaluated. Since 2011, a total of 107 evaluable patient bone scans were studied (n = 107). Patients with visceral metastases were excluded to evaluate only those with skeletal metastases. An automated bone scan index (aBSI) was generated for each scan using the Progenics Pharmaceuticals’ artificial intelligence platform. Multivariate analysis of aBSI with overall survival, prostate cancer specific survival, time from diagnosis to first positive bone scan, age at diagnosis, ethnicity, and Gleason score was assessed. Results: The study demonstrated a wide range of aBSI values (Range 0-16.84). Values calculated above the Median aBSI value (1.0) were prognostic for Overall Survival (p = 0.0009) and Prostate Cancer-Specific Survival (p = 0.0011). Patients in the highest quartile of aBSI values (range 5.2-16.84) showed a statistically significant Prostate Cancer-Specific Mortality (p = 0.0300) when compared to the lowest two quartiles (Range 0-1.07). The time from diagnosis to the first positive Tc99m bone scan statistically correlated with aBSI values (p = 0.0016). Multivariate analysis using Cox regression was utilized in the final statistical analysis of prostate cancer-specific mortality and overall survival. Conclusions: The automated Bone Scan Index provides a quantifiable and validated artificial intelligence biomarker to address an unmet need among metastatic prostate cancer patients. This tool was validated among Veterans, a pertinent population that is commonly affected by metastatic prostate cancer.

scholarly journals The Impact of Palliative Transurethral Resection of the Prostate on the Prognosis of Patients With Bladder Outlet Obstruction and Metastatic Prostate Cancer: A Population-Matched Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Kun Fang ◽  
Pan Song ◽  
Jiahe Zhang ◽  
Luchen Yang ◽  
Peiwen Liu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Transurethral Resection ◽  
Bladder Outlet Obstruction ◽  
Metastatic Prostate Cancer ◽  
Cox Regression ◽  
Outlet Obstruction ◽  
Survival Curves ◽  
Cancer Specific Survival ◽  
The Impact ◽  
Surgical Group

Objective: This study aimed to evaluate the survival outcomes of patients with bladder outlet obstruction (BOO) and metastatic prostate cancer (mPCa) after having a palliative transurethral resection of the prostate (pTURP) surgery.Methods: We identified patients with mPCa between 2004 and 2016 in the Surveillance, Epidemiology, and End Results (SEER) database. Patients who received pTURP and non-surgical therapy were identified. A propensity-score matching was introduced to balance the covariate. Kaplan–Meier analysis and COX regression were conducted to evaluate the overall survival (OS) and cancer-specific survival (CSS) outcomes.Results: A total of 36,003 patients were identified; 2,823 of them were in the pTURP group and 33,180 were in the non-surgical group. The survival curves of the overall cohort showed that the pTURP group was associated with worse outcomes in both OS (HR: 1.12, 95% CI: 1.07–1.18, p < 0.001) and CSS (HR: 1.08, 95% CI: 1.02–1.15, p = 0.004) compared with the non-surgical group. The mean survival time in the overall cohort of the pTURP group was shorter than the non-surgical group in both OS [35.13 ± 1.53 vs. 40.44 ± 0.59 months] and CSS [48.8 ± 1.27 vs. 55.92 ± 0.43 months]. In the matched cohort, the pTURP group had significantly lower survival curves for both OS (HR: 1.25, 95% CI: 1.16–1.35, p < 0.001) and CSS (HR: 1.23, 95% CI: 1.12–1.35, p < 0.001) than the non-surgical group. pTURP significantly reduced the survival months of the patients (36.49 ± 0.94 vs. 45.52 ± 1.23 months in OS and 50.1 ± 1.49 vs. 61.28 ± 1.74 months in CSS). In the multivariate COX analysis, pTURP increased the risk of overall mortality (HR: 1.19, 95% CI: 1.09–1.31, p < 0.001) and cancer-specific mortality CSS (HR: 1.23, 95% CI: 1.14–1.33, p < 0.001) compared with the non-surgical group.Conclusions: For mPCa patients with BOO, pTURP could reduce OS and CSS while relieving the obstruction.

scholarly journals Epidemiological Characteristics and Survival in Patients with de novo Metastatic Prostate Cancer.

2020 ◽  
Author(s):  
Carlo Cattrini ◽  
Davide Soldato ◽  
Alessandra Rubagotti ◽  
Linda Zinoli ◽  
Elisa Zanardi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Metastatic Prostate Cancer ◽  
Cox Regression ◽  
De Novo ◽  
Cancer Specific Survival ◽  
Risk Of Death ◽  
The Usa ◽  
Epidemiological Characteristics ◽  
Risk Of Cancer ◽  
Reduced Risk

The real-world outcomes of patients with metastatic prostate cancer (mPCa) are largely unexplored. We investigated the improvements in overall survival (OS) and cancer-specific survival (CSS) in patients with de novo mPCa in latest years. The USA SEER Research Data (2000-2017) were analyzed using the SEER*Stat software. The Kaplan-Meier method and Cox regression were used. Patients with de novo mPCa were allocated to 3 cohorts based on year of diagnosis: A (2000-2003), B (2004-2010), C (2011-2014). Maximum follow-up was fixed to 5 years. Overall, 26434 patients were included. Age, race and metastatic stage significantly affected OS and CSS. After adjustment for age and race, patients in cohort C showed 9% reduced risk of death (HR:0.91 [95% CI, 0.87-0.95], p<0.001) and 8% reduced risk of cancer-specific death (HR:0.91 [95% CI, 0.87-0.95], p<0.001) compared to those in cohort A. After adjustment for age, race and metastatic stage, patients in cohort C showed an improvement in OS and CSS compared to cohort B (HR:0.94 [95% CI, 0.91-0.97], p=0.001 and HR:0.89 [95% CI, 0.85-0.92], p<0.001). Patients with M1c disease had a more pronounced improvement in OS and CSS compared with the other stages. No differences were found between cohort B and C. In conclusion, the prognosis of de novo mPCa remains poor with a median OS of 30 months and a median CSS of 35 months. Limited OS and CSS improvements were observed in latest years.

scholarly journals Survival in Patients With Metastatic Prostate Cancer Undergoing Radiotherapy: The Importance of Prostate-Specific Antigen-Based Stratification

2021 ◽  
Vol 11 ◽  
Author(s):  
Zijian Tian ◽  
Lingfeng Meng ◽  
Xin Wang ◽  
Xuan Wang ◽  
Tianming Ma ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Prostate Specific Antigen ◽  
Metastatic Prostate Cancer ◽  
Large Population ◽  
Specific Antigen ◽  
Control Group ◽  
Cancer Specific Survival ◽  
Radiotherapy Group ◽  
Cox Analysis

ObjectivesTo explore the effectiveness of radiotherapy in mPCa patients with different PSA stratifications based on the cancer database of a large population.BackgroundScreening criteria for patients with metastatic prostate cancer, who are candidates for radiotherapy, are rarely reported.Patients and MethodsWe identified 22,604 patients with metastatic prostate cancer in the Surveillance, Epidemiology, and End Results database and divided them into a radiotherapy group and a control group. Patients with metastatic prostate cancer were divided into subgroups according to their levels of prostate-specific antigen to evaluate the efficacy of radiotherapy. They were also divided into six subgroups according to their prostate-specific antigen levels. We used multivariate Cox analysis to evaluate overall survival and cancer-specific survival. After 1:1 propensity score matching, Kaplan-Meier analysis was used to explore the difference in overall survival and cancer-specific survival in the radiotherapy and control group.ResultsIn all, 5,505 patients received radiotherapy, compared to 17,099 in the control group. In the multivariate Cox analysis, radiotherapy improved overall survival (hazard ratio [HR]: 0.730, 95% confidence interval [CI]: 0.636–0.838; P<0.001) and cancer-specific survival (HR: 0.764, 95% CI: 0.647–0.903; P=0.002) in patients with a PSA level of 4–10 ng/mL. Similar results were obtained by Kaplan-Meier analysis after 1:1 propensity score matching. In patients with prostate-specific antigen levels between 4–10 ng/mL, the overall survival (P<0.001) and cancer-specific survival (P<0.05) in the radiotherapy group was significantly better than those in the control group.ConclusionThe result of this large population-based study shows that rigorous selection of appropriate metastatic prostate cancer patients for radiotherapy can benefit prognosis significantly. This can be the basis for future prospective trials.

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