Predicting Time From Metastasis to Overall Survival in Castration-Resistant Prostate Cancer

Results From SEARCH

Daniel M. Moreira, Lauren E. Howard, Katharine N. Sourbeer, Hiruni S. Amarasekara, Lydia C. Chow, Dillon C. Cockrell, Connor L. Pratson, Brian T. Hanyok, William J. Aronson, Christopher J. Kane, Martha Kennedy Terris, Christopher L. Amling, Matthew R. Cooperberg, Stephen J. Freedland

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

We investigated the predictors of time from metastatic castration-resistant prostate cancer (mCRPC) to all-cause mortality among patients treated at Veteran Affairs hospitals. We found that age, more remote year of mCRPC, greater number of bone metastasis, higher prostate-specific antigen levels, and shorter prostate-specific antigen doubling time at mCRPC diagnosis were associated with shorter overall survival. A nomogram was generated yielding good concordance and calibration. Objective To identify the predictors of time from initial diagnosis of metastatic castration-resistance prostate cancer (mCRPC) to all-cause death within the Shared Equal Access Regional Cancer Hospital cohort. Patients and Methods We performed a retrospective analysis of 205 mCRPC men. Overall survival was estimated and plotted using the Kaplan-Meier method. The uni- and multivariable overall survival predictors were evaluated with the Cox proportional hazards model. A nomogram was generated to predict overall survival at 1, 2, 3, and 5 years after mCRPC. Concordance index and calibration plot were obtained. Results A total of 170 men (83%) died over a median follow-up of 41 months. In univariable analysis, older age, more remote year of mCRPC, nonblack race, greater number of bone metastasis, higher prostate-specific antigen (PSA) levels, shorter PSA doubling time, and faster PSA velocity at mCRPC diagnosis were significantly associated with shorter overall survival (all P < .05). In multivariable analysis, older age, more remote year of mCRPC, greater number of bone metastasis, higher PSA levels, and shorter PSA doubling time at mCRPC diagnosis remained significantly associated with shorter overall survival (all P < .05). On the basis of these variables, a nomogram was generated yielding a concordance index of 0.67 and good calibration. Conclusion The use of clinical parameter such as age, disease burden, and PSA levels and kinetics can be used to estimate overall survival in mCRPC patients.

Original languageEnglish (US)
Pages (from-to)60-66.e2
JournalClinical Genitourinary Cancer
Volume15
Issue number1
DOIs
StatePublished - Feb 1 2017

Fingerprint

Castration
Prostatic Neoplasms
Prostate-Specific Antigen
Neoplasm Metastasis
Survival
Nomograms
Calibration
Bone and Bones
Veterans Hospitals
Cancer Care Facilities
Proportional Hazards Models
Cause of Death

Keywords

  • Disease-free survival
  • Mortality
  • Prostate cancer
  • Prostate-specific antigen
  • Prostatectomy

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Moreira, D. M., Howard, L. E., Sourbeer, K. N., Amarasekara, H. S., Chow, L. C., Cockrell, D. C., ... Freedland, S. J. (2017). Predicting Time From Metastasis to Overall Survival in Castration-Resistant Prostate Cancer: Results From SEARCH. Clinical Genitourinary Cancer, 15(1), 60-66.e2. https://doi.org/10.1016/j.clgc.2016.08.018

Predicting Time From Metastasis to Overall Survival in Castration-Resistant Prostate Cancer : Results From SEARCH. / Moreira, Daniel M.; Howard, Lauren E.; Sourbeer, Katharine N.; Amarasekara, Hiruni S.; Chow, Lydia C.; Cockrell, Dillon C.; Pratson, Connor L.; Hanyok, Brian T.; Aronson, William J.; Kane, Christopher J.; Terris, Martha Kennedy; Amling, Christopher L.; Cooperberg, Matthew R.; Freedland, Stephen J.

In: Clinical Genitourinary Cancer, Vol. 15, No. 1, 01.02.2017, p. 60-66.e2.

Research output: Contribution to journalArticle

Moreira, DM, Howard, LE, Sourbeer, KN, Amarasekara, HS, Chow, LC, Cockrell, DC, Pratson, CL, Hanyok, BT, Aronson, WJ, Kane, CJ, Terris, MK, Amling, CL, Cooperberg, MR & Freedland, SJ 2017, 'Predicting Time From Metastasis to Overall Survival in Castration-Resistant Prostate Cancer: Results From SEARCH', Clinical Genitourinary Cancer, vol. 15, no. 1, pp. 60-66.e2. https://doi.org/10.1016/j.clgc.2016.08.018
Moreira, Daniel M. ; Howard, Lauren E. ; Sourbeer, Katharine N. ; Amarasekara, Hiruni S. ; Chow, Lydia C. ; Cockrell, Dillon C. ; Pratson, Connor L. ; Hanyok, Brian T. ; Aronson, William J. ; Kane, Christopher J. ; Terris, Martha Kennedy ; Amling, Christopher L. ; Cooperberg, Matthew R. ; Freedland, Stephen J. / Predicting Time From Metastasis to Overall Survival in Castration-Resistant Prostate Cancer : Results From SEARCH. In: Clinical Genitourinary Cancer. 2017 ; Vol. 15, No. 1. pp. 60-66.e2.
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AU - Amarasekara, Hiruni S.

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