Survival and clinical metastases among prostate cancer patients treated with androgen deprivation therapy in Sweden |
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| Institution: | 1. Quantify Research, Hantverkargatan 8, 112 21 Stockholm, Sweden;2. Amgen Inc., Center for Observational Research, South San Francisco, CA, United States;3. Institute of Environmental Medicine, Karolinska Institute, 171 77 Stockholm, Sweden;4. Department of Public Health and Caring Sciences, Uppsala University, 751 22 Uppsala, Sweden;5. Amgen Inc., Center for Observational Research, One Amgen Center Drive 24-2-A, Thousand Oaks, CA 91320, United States;6. IMS Health/Pygargus, Sveavägen 155, 113 46 Stockholm, Sweden;7. LIME/Medical Management Centre, Karolinska Institute, 171 77 Stockholm, Sweden;8. Uppsala University, 751 05 Uppsala, Sweden;1. Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan;2. Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan;3. Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Dou-Liou City, Yun-Lin County, Taiwan;4. Cardiovascular Center, National Taiwan University Hospital Yun-Lin Branch, Dou-Liou City, Yun-Lin County, Taiwan;5. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan;1. Cancer Epidemiology & Health Services Research Group, Centre for Public Health, Queen''s University Belfast, Northern Ireland, UK;2. Centre for Cancer Research and Cell Biology, Queen''s University Belfast, Northern Ireland, UK;3. Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Northern Ireland, UK;4. Department of Cellular Pathology, Queen''s Medical Centre, Nottingham University Hospitals NHS Trust, UK;5. The John van Geest Cancer Research Centre, Nottingham Trent University, Clifton Lane, Nottingham NG11 8NS, UK;1. Inserm, center for research in epidemiology and population health (CESP), U1018, gene, environment cancer epidemiology team, 94807 Villejuif cedex, France;2. UMRS 1018, Paris-Sud University, 94807 Villejuif cedex, France;3. Hepato-gastroenterology department, unit of gastrointestinal tumor screening and treatment, Pitié-Salpêtrière hospital, Paris Public Hospital Authority (AP–HP), 75013 Paris, France;4. National Health Insurance Organization for Salaried Workers (CNAM), 75986 Paris cedex 20, France;1. Oslo University Hospital, Oslo, Norway;2. Division of Surgery and Interventional Science, University College London and Department of Urology, University College Hospitals National Health Service Foundation Trust, London, United Kingdom;3. Department of Urology, North Hampshire and Basingstoke Hospital, Hampshire Hospitals National Health Service Foundation Trust, Basingstoke, United Kingdom;1. Servicio de Urología, Hospital Virgen de las Nieves, Granada, España;2. Servicio de Urología, Hospital Morales Meseguer, Murcia, España;3. Fundació Puigvert, Barcelona, España;4. Servicio de Urología, Hospital Universitario Virgen del Rocío, Sevilla, España;5. Servicio de Urología, Hospital Universitario 12 de Octubre, Madrid, España;6. Servicio de Urología, Hospital Vall d?Hebron, Barcelona, España;7. Servicio de Urología, Hospital Clínic de Barcelona, Barcelona, España;8. Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España;9. Servicio de Urología, Hospital Universitario Virgen Macarena, Sevilla, España;10. Servicio de Urología, Hospital Reina Sofía, Córdoba, España;11. Servicio de Urología, Hospital Clínico San Carlos, Madrid, España;12. Servicio de Urología, Hospital Puerta de Hierro, Madrid, España;13. Servicio de Urología, Hospital Carlos Haya, Málaga, España;1. Servicio de Urología, Complejo Asistencial Universitario de León, León, España;2. Grupo de Investigación en Interacción Gen-Ambiente-Salud, Universidad de León, León, España;3. Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España;4. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España;5. Servicio de Anatomía Patológica, Complejo Asistencial Universitario de León, León, España |
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| Abstract: | ObjectivesTo examine the incidence of metastases and clinical course of prostate cancer patients who are without confirmed metastasis when initiating androgen deprivation therapy (ADT).MethodsRetrospective cohort study conducted using electronic medical records from Swedish outpatient urology clinics linked to national mandatory registries to capture medical and demographic data. Prostate cancer patients initiating ADT between 2000 and 2010 were followed from initiation of ADT to metastasis, death, and/or end of follow-up.ResultsThe 5-year cumulative incidence (CI) of metastasis was 18%. Survival was 60% after 5 years; results were similar for bone metastasis-free survival. The 5-year CI of castration-resistant prostate cancer (CRPC) was 50% and the median survival from CRPC development was 2.7 years. Serum prostate-specific antigen (PSA) levels and PSA doubling time were strong predictors of bone metastasis, any metastasis, and death.ConclusionThis study provides understanding of the clinical course of prostate cancer patients without confirmed metastasis treated with ADT in Sweden. Greater PSA values and shorter PSA doubling time (particularly ≤ 6 months) were associated with increased risk of bone metastasis, any metastasis, and death. |
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| Keywords: | ADT CRPC Metastasis Prostate cancer PSA |
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