Prognosis of men with high-risk prostate cancer stratified by risk factors: a population-based retrospective cohort study

e15147 Background: Androgen deprivation therapy (ADT) is the cornerstone treatment of advanced PC, but is frequently used in the M0 setting. After a variable period of hormone-sensitivity, most patients develop CR disease (rising prostate-specific antigen [PSA] despite ongoing ADT). These men are at increased risk of developing bone metastases (BMT), particularly in those with higher serum PSA and shorter PSA doubling time (DT). The epidemiology and natural history of M0 CRPC has not been well-studied in a population-based setting. Methods: A retrospective cohort study was conducted using HFHS administrative data and included 691 men diagnosed with M0 PC between 1996 and 2005, who received ADT, with serial PSA measurements to determine CR. Patient records through 12/31/2008 were reviewed for outcomes of interest. CRPC was defined as 2 consecutive PSA rises, with “high risk” defined as PSA ≥8 ng/mL or PSA DT ≤10 months (mos) after the development of CRPC (Smith MR et al. Lancet 379:39-46, 2012). The risk of BMT was estimated for the entire cohort and for the CRPC and high-risk CRPC subsets. Results: Of the 691 patients included in the cohort (median age: 73 years, 48% African American), 98% received only GnRH agonists and 2% had orchiectomy. Median follow-up for the entire cohort after ADT initiation was 49 mos (IQR=45). 101 patients (15%) met criteria for CRPC during follow-up, with a median of 18 mos on active ADT prior to CRPC development (IQR=14). Of CRPC patients, 85% met criteria for high-risk (of those, 16% had PSA ≥8 ng/mL, 12% had PSA DT ≤10 mos, and 72% had both). Among all patients, 12% (n=82) developed BMT during follow-up, with 42% (n=36) of the high-risk CRPC subset developing BMT. Median time from high-risk CRPC to BMT was 9 mos (IQR=17). Conclusions: The HFHS resource allowed for our investigation of PSA characteristics corresponding to disease progression in a racially diverse patient population. A substantial proportion of M0 PC patients on ADT will eventually develop CR disease. Once a patient has CRPC, the risk of BMT is relatively high.

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The prevalence and risk factors of preterm small-for-gestational-age infants: a population-based retrospective cohort study in rural Chinese population

BMC Pregnancy and Childbirth ◽

10.1186/s12884-017-1412-7 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 8

Author(s):

Shi Chen ◽

Rong Zhu ◽

Huijuan Zhu ◽

Hongbo Yang ◽

Fengying Gong ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Gestational Age ◽

Small For Gestational Age ◽

Retrospective Cohort Study ◽

Chinese Population ◽

Retrospective Cohort ◽

Population Based

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Treatment with curative intent and survival in men with high-risk prostate cancer. A population-based study of 11 380 men with serum PSA level 20-100 ng/mL

BJU International ◽

10.1111/j.1464-410x.2012.11320.x ◽

2012 ◽

Vol 111 (3) ◽

pp. 381-388 ◽

Cited By ~ 8

Author(s):

Sam Ladjevardi ◽

Anders Berglund ◽

Eberhard Varenhorst ◽

Ola Bratt ◽

Anders Widmark ◽

...

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Population Based ◽

Curative Intent ◽

Population Based Study ◽

High Risk Prostate Cancer ◽

Risk Prostate Cancer

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Association of Radical Local Treatment with Mortality in Men with Very High-risk Prostate Cancer: A Semiecologic, Nationwide, Population-based Study

European Urology ◽

10.1016/j.eururo.2016.07.023 ◽

2017 ◽

Vol 72 (1) ◽

pp. 125-134 ◽

Cited By ~ 13

Author(s):

Pär Stattin ◽

Fredrik Sandin ◽

Frederik Birkebæk Thomsen ◽

Hans Garmo ◽

David Robinson ◽

...

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Local Treatment ◽

Population Based ◽

Population Based Study ◽

High Risk Prostate Cancer ◽

Risk Prostate Cancer ◽

Very High

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Survival Benefit of Patients Aged≥ 75 Years Diagnosed With High-risk Non-metastatic Prostate Cancerafter Definitive Treatmentof the Primary Tumor: A Population-based Study

10.21203/rs.3.rs-34681/v1 ◽

2020 ◽

Author(s):

JunJie Yu ◽

Bin Xu ◽

Ming Chen

Keyword(s):

Prostate Cancer ◽

Logistic Regression ◽

High Risk ◽

Marital Status ◽

Survival Benefit ◽

Population Based ◽

Older Age ◽

High Risk Prostate Cancer ◽

Risk Prostate Cancer ◽

N Stage

Abstract Background:The survival benefit of active treatment for high-risk prostate cancer patients aged≥ 75 years remains controversial. We further evaluated the effect of definitive treatment(DT) for those patients in a population-based cohort.Methods:Retrospective analysis of 17848 elderly (≥75 years) men in the Surveillance, Epidemiology, and End Results(SEER) database(2004-2016) who diagnosed non-metastatic high-risk prostate cancer. Kaplan-Meiersurvival curves were used to compare cancer-specific survival (CSS) and overall survival (OS). Propensity-adjusted multivariate Cox regression analysis fitted to identify independent prognostic factors. Logistic regression models were used as a predictor for DT.Results:A total of 17848 patients were identified, 10365 patients receiving DT (including 4284 receiving surgery, 5683 receiving EBRT, 367 receiving BT, 569 receiving EBRT+BT, 92receiving Chemotherapy) and 7473 receiving non-DT. PSM methods wereperformedand compared all baseline factors, including insurance/marital status, age, race,T /N stage, grade, Gleason score(GS),PSA. After PSM, these two groups achieved a median survival time (MST) of 99, 67months for OS, respectively(P<0.01).And older age (age ≥ 80 years) status showed a worse survival benefit (P<0.01). The subgroup analysis illustrated that surgery(MST=122) vsEBRT(MST=111) vs BT(MST=116) vs EBRT+BT(MST=121) subgroups achieved better OS than Chemotherapy group(MST=66)(P<0.01). However, EBRT+BT subgroup had better 3- and 5-year OS (93% and 82.2%). Multivariate Cox proportional hazards model showed unmarried status, older age (age ≥ 80 years), T4 stage, high tumor grade, PSA ≥10 ng/mL were significantly associated with a worse OS, whereas DT (HR, 0.65; p < 0.001) and other race(HR, 0.773; p < 0.001) were associated with a better OS. And logistic regression illustrated that poor differentiated grade was independently predictor (OR=1.427;p=0.022)Conclusions: This study indicated that insurance status, marital status, age, race, T /N stage, grade, GS, PSA and treatment modalities affected OS and CSS in elderly men with non-metastatic high-risk prostate cancer. DT, especially surgery and radiotherapy, might provide favorable OS not CSS compared with NDT for older patients (≥75 years), whereas chemotherapy was not recommended.

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