scholarly journals Predictive Factor to Castrate-Resistant Prostate Cancer (CRPC) after Primary Androgen Deprivation Therapy (ADT): Single Center Experience in Indonesia

2020 ◽  
Vol 9 (3S) ◽  
pp. 308-312
Keyword(s):  
Prostate Cancer ◽  
Proportional Hazards ◽  
Study Data ◽  
Cox Proportional Hazards ◽  
Cancer Stage ◽  
Testosterone Levels ◽  
Single Center Experience ◽  
Significant Independent Factor ◽  
Castrate Resistant ◽  
Prostate Cancer Stage

ADT is the main therapy in prostate cancer, especially in advanced stages, although ADT does not limit the progression of this disease to become CRPC, where the mortality rate will be much higher when CRPC has occurred. This study aims to examine corellating factors influenced the short duration to CRPC after primary ADT administration. 205 prostate cancer patients with CRPC or mCRPC in Saiful Anwar Malang Hospital from 2013 to 2018 were included in this study. Data recorded were age, initial PSA level, Gleason score, prostate cancer stage, type of ADT, nadir PSA, time between ADT and nadir PSA, and testosterone levels after ADT. To see the independent factors that influence the occurrence of CRPC, the Cox proportional hazards regression model was used. The average age of patients was 67, 53  6.86 years with an average level of initial PSA of 674.87  1405.80 80 / dL. The average time for CRPC to occur was 24.7  9.74 months. In multivariate analysis it was found that the stage of cancer with metastasis (HR 1,616, p 0,048), testosterone level after ADT was > 20ng / dL (HR 4,638, p 0,000), nadir PSA > 4ng / dL (HR 1,716, p 0,023) and time to reach Nadir PSA <6 months (HR 1.596, p 0.004) is a significant independent factor for CRPC occurrence. The conclusion is cancer stage, testosterone levels after ADT, nadir PSA and time needed to reach nadir PSA were independent factors for CRPC in patients with prostate cancer who had primary ADT.

scholarly journals Identification of subgroups of metastatic castrate-resistant prostate cancer (mCRPC) patients treated with abiraterone plus prednisone at low- vs. high-risk of radiographic progression: An analysis of COU-AA-302

2018 ◽  
Vol 13 (6) ◽  
Author(s):  
Lisa J. Martin ◽  
Shabbir M.H. Alibhai ◽  
Maria Komisarenko ◽  
Narhari Timilshina ◽  
Antonio Finelli
Keyword(s):  
Prostate Cancer ◽  
Radiographic Progression ◽  
Proportional Hazards ◽  
Specific Antigen ◽  
Progression Free Survival ◽  
Limited Resource ◽  
Abiraterone Acetate ◽  
Cox Proportional Hazards ◽  
Castrate Resistant Prostate Cancer ◽  
Castrate Resistant

Introduction: Radiographic imaging is used to monitor disease progression for men with metastatic castrate-resistant prostate cancer (mCRPC). The optimal frequency of imaging, a costly and limited resource, is not known. Our objective was to identify predictors of radiographic progression to inform the frequency of imaging for men with mCRPC. Methods: We accessed data for men with chemotherapy-naive mCRPC in the abiraterone acetate plus prednisone (AA-P) group of a randomized trial (COU-AA-302) (n=546). We used Cox proportional hazards modelling to identify predictors of time to progression. We divided patients into groups based on the most important predictors and estimated the probability of radiographic progression-free survival (RPFS) at six and 12 months. Results: Baseline disease and change in prostate-specific antigen (PSA) at eight weeks were the strongest determinants of RPFS. The probability of RPFS for men with bone-only disease and a ≥50% fall in PSA was 93% (95% confidence interval [CI] 87–96) at six months and 80% (95% CI 72–86) at 12 months. In contrast, the probability of RPFS for men with bone and soft tissue metastasis and <50% fall in PSA was 55% (95% CI 41–67) at six months and 34% (95% CI 22–47) at 12 months. These findings should be externally validated. Conclusions: Patients with chemotherapy-naive mCRPC treated with first-line AA-P can be divided into groups with significantly different risks of radiographic progression based on a few clinically available variables, suggesting that imaging schedules could be individualized.

scholarly journals Impact of comorbidity on the outcome in men with advanced prostate cancer treated with docetaxel

2015 ◽  
Vol 49 (4) ◽  
pp. 402-408 ◽  
Author(s):  
Andrej Zist ◽  
Eitan Amir ◽  
Alberto F. Ocana ◽  
Bostjan Seruga
Keyword(s):  
Prostate Cancer ◽  
Proportional Hazards ◽  
Hospital Admissions ◽  
Univariate Analysis ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Severe Comorbidity ◽  
Castrate Resistant Prostate Cancer ◽  
Castrate Resistant ◽  
The Impact

Abstract Background. Men with metastatic castrate-resistant prostate cancer (mCRPC) may not receive docetaxel in everyday clinical practice due to comorbidities. Here we explore the impact of comorbidity on outcome in men with mCRPC treated with docetaxel in a population-based outcome study. Methods. Men with mCRPC treated with docetaxel at the Institute of Oncology Ljubljana between 2005 and 2012 were eligible. Comorbidity was assessed by the age-adjusted Charlson comorbidity index (aa-CCI) and adult comorbidity evaluation (ACE-27) index. Hospital admissions due to the toxicity and deaths during treatment with docetaxel were used as a measure of tolerability. Association between comorbidity and overall survival (OS) was tested using the Cox proportional hazards analysis. Results. Two hundred and eight men were treated with docetaxel. No, mild, moderate and severe comorbidity was present in 2%, 32%, 53% and 13% using aa-CCI and in 27%, 35%, 29% and 8% when assessed by ACE-27. A substantial dose reduction of docetaxel occurred more often in men with moderate or severe comorbidity as compared to those with no or mild comorbidity. At all comorbidity levels about one-third of men required hospitalization or died during treatment with docetaxel. In univariate analysis a higher level of comorbidity was not associated with worse OS (aa-CCI HR 0.99; [95% CI 0.87–1.13], p = 0.93; ACE-27: HR 0.96; [95% CI 0.79–1.17], p = 0.69). Conclusions. Men with mCRPC, who have comorbidities may benefit from treatment with docetaxel.

scholarly journals Survival rates and prognostic factors in right- and left-sided colon cancer stage I–IV: an unselected retrospective single-center trial

2021 ◽  
Author(s):  
Claudius E. Degro ◽  
Richard Strozynski ◽  
Florian N. Loch ◽  
Christian Schineis ◽  
Fiona Speichinger ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Blood Level ◽  
Proportional Hazards ◽  
Survival Rates ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Cancer Stage ◽  
Single Center ◽  
Significant Difference

Abstract Purpose Colorectal cancer revealed over the last decades a remarkable shift with an increasing proportion of a right- compared to a left-sided tumor location. In the current study, we aimed to disclose clinicopathological differences between right- and left-sided colon cancer (rCC and lCC) with respect to mortality and outcome predictors. Methods In total, 417 patients with colon cancer stage I–IV were analyzed in the present retrospective single-center study. Survival rates were assessed using the Kaplan–Meier method and uni/multivariate analyses were performed with a Cox proportional hazards regression model. Results Our study showed no significant difference of the overall survival between rCC and lCC stage I–IV (p = 0.354). Multivariate analysis revealed in the rCC cohort the worst outcome for ASA (American Society of Anesthesiologists) score IV patients (hazard ratio [HR]: 16.0; CI 95%: 2.1–123.5), CEA (carcinoembryonic antigen) blood level > 100 µg/l (HR: 3.3; CI 95%: 1.2–9.0), increased lymph node ratio of 0.6–1.0 (HR: 5.3; CI 95%: 1.7–16.1), and grade 4 tumors (G4) (HR: 120.6; CI 95%: 6.7–2179.6) whereas in the lCC population, ASA score IV (HR: 8.9; CI 95%: 0.9–91.9), CEA blood level 20.1–100 µg/l (HR: 5.4; CI 95%: 2.4–12.4), conversion to laparotomy (HR: 14.1; CI 95%: 4.0–49.0), and severe surgical complications (Clavien-Dindo III–IV) (HR: 2.9; CI 95%: 1.5–5.5) were identified as predictors of a diminished overall survival. Conclusion Laterality disclosed no significant effect on the overall prognosis of colon cancer patients. However, group differences and distinct survival predictors could be identified in rCC and lCC patients.

scholarly journals Risk and Timing of Cardiovascular Disease After Androgen-Deprivation Therapy in Men With Prostate Cancer

2015 ◽  
Vol 33 (11) ◽  
pp. 1243-1251 ◽  
Author(s):  
Sean O'Farrell ◽  
Hans Garmo ◽  
Lars Holmberg ◽  
Jan Adolfsson ◽  
Pär Stattin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cardiovascular Disease ◽  
Androgen Deprivation Therapy ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Androgen Deprivation ◽  
Gnrh Agonists ◽  
Cvd Risk ◽  
Comparison Cohort ◽  
Using Data

Purpose Findings on the association between risk of cardiovascular disease (CVD) and the duration and type of androgen-deprivation therapy (ADT) in men with prostate cancer (PCa) are inconsistent. Methods By using data on filled drug prescriptions in Swedish national health care registers, we investigated the risk of CVD in a cohort of 41,362 men with PCa on ADT compared with an age-matched, PCa-free comparison cohort (n = 187,785) by use of multivariable Cox proportional hazards regression models. Results From 2006 to 2012, 10,656 men were on antiandrogens (AA), 26,959 were on gonadotropin-releasing hormone (GnRH) agonists, and 3,747 underwent surgical orchiectomy. CVD risk was increased in men on GnRH agonists compared with the comparison cohort (hazard ratio [HR] of incident CVD, 1.21; 95% CI, 1.18 to 1.25; and orchiectomy: HR, 1.16; 95% CI, 1.08 to 1.25). Men with PCa on AA were at decreased risk (HR of incident CVD, 0.87; 95% CI, 0.82 to 0.91). CVD risk was highest during the first 6 months of ADT in men who experienced two or more cardiovascular events before therapy, with an HR of CVD during the first 6 months of GnRH agonist therapy of 1.91 (95% CI, 1.66 to 2.20), an HR of CVD with AA of 1.60 (95% CI, 1.24 to 2.06), and an HR of CVD with orchiectomy of 1.79 (95% CI, 1.16 to 2.76) versus the comparison cohort. Conclusion Our results support that there should be a solid indication for ADT in men with PCa so that benefit outweighs potential harm; this is of particular importance among men with a recent history of CVD.

Abstract T MP48: Androgen Suppression in Patients with Prostate Cancer Increases Incidence of Combined Cardiovascular Outcomes

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Zuber S Ali ◽  
Danielle M Greere ◽  
Robyn L Shearer ◽  
Syed Ali Gardezi ◽  
Arshad Jahangir
Keyword(s):  
Prostate Cancer ◽  
Proportional Hazards ◽  
Age Groups ◽  
The Elderly ◽  
Cox Proportional Hazards ◽  
Cardiovascular Outcomes ◽  
Elevated Risk ◽  
Disease Stage ◽  
Cox Proportional Hazards Models ◽  
Androgen Suppression

Introduction: Androgen suppression therapy for prostate cancer is controversial due to adverse fatal and non-fatal cardiovascular outcomes reported in some studies. However, effects of androgen suppression on stroke have not been fully assessed in the elderly. Methods: Patients diagnosed with prostate cancer during 2007-2013 in a large community-based healthcare system were identified from the Cancer Registry, electronic records, and billing codes. Those who underwent androgen suppression therapy with Gonadotropin-releasing hormone agonist (GnRH) were propensity-matched to patients treated without androgen suppression therapy by age at cancer diagnosis, race/ethnicity, disease stage and outcome, body mass index and use of surgery, radiation, and chemotherapy. Tests of independence and Cox proportional hazards models were used to examine effects of hormone therapy on acute myocardial infarction (AMI), stroke, and mortality outcomes. Models also adjusted for patient comorbidities. Results: A total of 1282 patients and 641 matched-pairs were identified, with mean diagnosis age of 69 yr and follow-up period of 3.05 yr. Effects of androgen suppression therapy on AMI (P=0.051) and stroke (P=0.062) were of marginal to non-significance, but adjusted-odds of death and combined AMI, stroke, and death were 1.61 times (P=0.002; odds ratio [OR] 95% CI: 1.19-2.18) and 1.70 times (P<0.001; OR 95% CI: 1.26-2.28) greater, respectively, for men with than without androgen suppression. An interaction of androgen suppression and age-group (<65 yr, 65-74 yr, >74 yr) was discovered for combined outcomes, suggesting increased probability of AMI, stroke, and/or death with age (8.6-20.0%; P=0.003) for patients without androgen suppression but elevated risk of outcomes across all age groups (18.3-22.4%; P=0.546) for men treated with androgen suppression therapy. Conclusion: Endogenous androgen suppression presents elevated risk of combined cardiovascular and death outcomes, especially for men <65 yr.

scholarly journals Prostate cancer-specific survival differences in patients treated by radical prostatectomy versus curative radiotherapy

2013 ◽  
Vol 7 (5-6) ◽  
pp. 299 ◽  
Author(s):  
Julie M. DeGroot ◽  
Michael D. Brundage ◽  
Miu Lam ◽  
Susan L. Rohland ◽  
Jeremy Heaton ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Proportional Hazards ◽  
Risk Groups ◽  
Cox Proportional Hazards ◽  
Intermediate Risk ◽  
Cancer Specific Survival ◽  
Entire Study ◽  
Curative Radiotherapy ◽  
The Impact ◽  
Cause Specific Survival

Objective: We compared the cause-specific survival of patientswho received radiotherapy to those who received surgery for cureof their prostate cancer using a number of design and analytic stepsto mitigate confounding by indication.Methods: This was a case-cohort study of 2213 patients in theOntario Cancer Registry diagnosed between 1990 and 1998 whowere either treatment candidates or received curative radiotherapyor surgery. Cases included patients who died of prostate cancerwithin 10 years. The study population was restricted to those whowere candidates for either treatment (radiotherapy or surgery)based on disease severity (low and intermediate risk using theGenitourinary Radiation Oncologists of Canada risk groups). Themedian follow-up was 51 months. Cause-specific survival wasanalyzed using Cox-proportional hazards regression with casecohortvariance adjustment.Results from intent-to-treat analyseswere compared to results by treatment received.Results: Adjusted hazard ratios for risk of prostate cancer death forradiotherapy compared to surgery for the entire study populationwere 1.62 (95%CI 1.00-2.61) and 2.02 (1.19-3.43) analyzing byintent-to-treat and treatment received, respectively. Intent-to-treathazard ratios for the low- and intermediate-risk groups were 0.87(0.28-2.76) and 1.57 (0.95-2.61), respectively.Conclusion: Overall results were driven by the finding in the intermediate-risk group, which indicated that radiotherapy was not aseffective as surgery in this group. Confirmation was needed withspecial attention paid to risk stratification and the impact of morecontemporary delivery of these treatment options.

Explaining the Race Difference in Prostate Cancer Stage at Diagnosis

2008 ◽  
Vol 17 (10) ◽  
pp. 2825-2834 ◽  
Author(s):  
B. A. Jones ◽  
W.-L. Liu ◽  
A. B. Araujo ◽  
S. V. Kasl ◽  
S. N. Silvera ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Stage ◽  
Stage At Diagnosis ◽  
Race Difference ◽  
Prostate Cancer Stage
Sign in / Sign up

Export Citation Format

Share Document