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.