Clinical features and prognostic factors for patients with bone metastases from prostate cancer

Abstract

To identify the clinical features and independent predictors of survival in patients with bone metastases from prostate cancer (PCa). We retrospectively analysed 115 PCa patients with bone metastases between 1997 and 2009. The overall survival rate after bone metastases was calculated using the Kaplan-Meier method. The prognostic factors were identified by univariate analysis using a log-rank test and by multivariate analysis using Cox proportional hazards regression models. The follow-up rate was 100%, the follow-up cases during 1, 3 and 5 years were 103, 79 and 55, respectively. The 1-, 3-and 5-year survival rates were 89.1%, 60.9% and 49.8%, respectively, with a median survival time of 48.5 months for patients with bone metastases from PCa. In univariate analysis, age, Gleason score, clinical stage, the number of bone lesions, alkaline phosphatase (ALP) level, invasion of neighbouring organs and non-regional lymph node metastases were correlated with prognosis. By multivariate analysis using Cox regression, ALP level, Gleason score and non-regional lymph node metastases were independent prognostic factors. These prognostic factors will help us to determine the appropriate dose and fraction of radiotherapy for these patients. INTRODUCTIONProstate cancer (PCa), the most common carcinoma in the industrialised world, has had increasing incidence in China. It is the only solid tumour diagnosed with its first recurrence as bone metastases instead of visceral metastases. 1 The bones are among the most frequent distant metastatic sites for PCa, occurring in 85%-100% patients. 2 Some studies 3-5 have been undertaken to identify prognostic factors for PCa, but less research has been undertaken on bone metastases regularity, especially on the Chinese mainland.In this retrospective study, 115 cases of PCa with bone metastases were collected, and the clinical features and main prognostic factors, including age, Gleason score, stage, endocrine therapy, castration, radiotherapy, number of bone lesions, prostate-specific antigen (PSA) and alkaline phosphatase (ALP) levels, neighbouring organ metastases, regional and remote lymph node metastases, surrounding parenchyma invaded and other visceral metastases were analysed to determine treatment strategies and to predict the reactions of the patients to treatment.

Clinical features and treatment strategies for older prostate cancer patients with bone metastasis

“…b Defined as brain, lung and liver metastases. the advantage of radiotherapy, 6 and the results were similar to those of another recent study. 15 However, in the current study, the older patients who received radiotherapy showed a lower survival rate when compared with the younger patients.…”

“…9,12 In the current study, the median overall survival of patients with Gleason scores .8 was significantly shorter than that of the lower scoring patients, which is consistent with our previous study. 6 Cheville et al 13 and Yigitbasi et al 9 have also reported that among patients with bone metastases, the Gleason score of the primary prostate adenocarcinoma is strongly associated with patient outcome. Saeter et al 14 found that the survival of patients with soft tissue or non-regional lymph node metastasis was similar to that of patients presenting with skeletal metastasis only, but few studies have discussed the prognostic value of these factors.…”

“…Minimal disease, better Southwest Oncology Group performance status, no bone pain, lower Gleason score and lower prostate-specific antigen (PSA) level were independent factors associated with longer survival. 5 In our previous study, we found that bone metastasis of PCa was more common in older males, 6 but no prognostic factors for these PCa patients were identified. In this retrospective study, the sample size was enlarged and 205 PCa patients older than 70 with bone metastases were included.…”

“…The data for the young patients were partially derived from our previous study. 6 All of the patients were confirmed as having primary PCa by pathological diagnosis and were diagnosed with bone metastasis through radioisotope scanning or magnetic resonance imaging. rib metastasis was considered as one metasitasis; in the statistical evaluation, the number of bone metastases was assessed as either single or multiple.…”

Prognostic factors in Chinese patients with metastatic castration-resistant prostate cancer treated with docetaxel-based chemotherapy

“…[7][8][9][10][11][12][13][14] However, the magnitude of the benefit provided by each factor has varied among studies, and the value of these factors in predicting overall survival (OS) for Chinese patients is still unclear. In the present study, we retrospectively analysed the data from 115 mCRPC patients treated with docetaxel to explore the prognostic factors of survival outcomes in Chinese patients.…”