Predictors of skeletal-related events and mortality in men with metastatic, castration-resistant prostate cancer: Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database

Ingrid Lorese Tablazon, Lauren E. Howard, Amanda M. De Hoedt, William J. Aronson, Christopher J. Kane, Christopher L. Amling, Matthew R. Cooperberg, Martha K. Terris, Stephen J. Freedland, Stephen B. Williams

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Although skeletal-related events (SREs) are linked with a reduced quality of life and worse outcomes, to the authors' knowledge the factors that predict SREs are minimally understood. The objective of the current study was to identify predictors of SREs and all-cause mortality among men with metastatic castration-resistant prostate cancer (mCRPC). Methods: Data were collected on 837 men with bone mCRPC at 8 Veterans Affairs medical centers within the Shared Equal Access Regional Cancer Hospital (SEARCH) database from 2000 through 2017. Patients were followed to assess development of SREs (pathological fracture, radiotherapy to bone, spinal cord compression, or surgery to bone). Cox proportional hazards models were used to evaluate predictors of SREs and mortality. Results: Of the 837 men with bone mCRPC, 287 developed a SRE and 740 men died (median follow-up, 26 months). Bone pain was found to be the strongest predictor of SREs (hazard ratio [HR], 2.96; 95% CI, 2.25-3.89). A shorter time from CRPC to the development of metastasis (HR, 0.92; 95% CI, 0.85-0.99), shorter progression to CRPC (HR, 0.94; 95% CI, 0.91-0.98), and visceral metastasis at the time of diagnosis of bone metastasis (HR, 1.91; 95% CI, 1.18-3.09) were associated with an increased risk of SREs. Ten or more bone metastases (HR, 2.17; 95% CI, 1.72-2.74), undergoing radical prostatectomy (HR, 0.73; 95% CI, 0.61-0.89), shorter progression to CRPC (HR, 0.97; 95% CI, 0.94-0.99), older age (HR, 1.03; 95% CI, 1.02-1.04), higher prostate-specific antigen level at the time of diagnosis of metastasis (HR, 1.21; 95% CI, 1.14-1.28), bone pain (HR, 1.44; 95% CI, 1.23-1.70), and visceral metastasis (HR, 1.72; 95% CI, 1.23-2.39) were associated with an increased mortality risk. Conclusions: Among men with bone mCRPC, bone pain was found to be the strongest predictor of SREs and the number of bone metastases was a strong predictor of mortality. If validated, these factors potentially may be used for risk stratification and for SRE prevention strategies.

Original languageEnglish (US)
Pages (from-to)4003-4010
Number of pages8
JournalCancer
Volume125
Issue number22
DOIs
StatePublished - Nov 15 2019

Fingerprint

Cancer Care Facilities
Castration
Prostatic Neoplasms
Databases
Bone and Bones
Mortality
Neoplasm Metastasis
Pain
Bone Neoplasms
Spontaneous Fractures
Spinal Cord Compression
Veterans
Prostate-Specific Antigen
Prostatectomy
Proportional Hazards Models
Radiotherapy
Quality of Life

Keywords

  • Shared Equal Access Regional Cancer Hospital (SEARCH)
  • bone
  • metastasis
  • predictors
  • prostate cancer
  • skeletal events

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Predictors of skeletal-related events and mortality in men with metastatic, castration-resistant prostate cancer : Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. / Tablazon, Ingrid Lorese; Howard, Lauren E.; De Hoedt, Amanda M.; Aronson, William J.; Kane, Christopher J.; Amling, Christopher L.; Cooperberg, Matthew R.; Terris, Martha K.; Freedland, Stephen J.; Williams, Stephen B.

In: Cancer, Vol. 125, No. 22, 15.11.2019, p. 4003-4010.

Research output: Contribution to journalArticle

Tablazon, IL, Howard, LE, De Hoedt, AM, Aronson, WJ, Kane, CJ, Amling, CL, Cooperberg, MR, Terris, MK, Freedland, SJ & Williams, SB 2019, 'Predictors of skeletal-related events and mortality in men with metastatic, castration-resistant prostate cancer: Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database', Cancer, vol. 125, no. 22, pp. 4003-4010. https://doi.org/10.1002/cncr.32414
Tablazon, Ingrid Lorese ; Howard, Lauren E. ; De Hoedt, Amanda M. ; Aronson, William J. ; Kane, Christopher J. ; Amling, Christopher L. ; Cooperberg, Matthew R. ; Terris, Martha K. ; Freedland, Stephen J. ; Williams, Stephen B. / Predictors of skeletal-related events and mortality in men with metastatic, castration-resistant prostate cancer : Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. In: Cancer. 2019 ; Vol. 125, No. 22. pp. 4003-4010.
@article{5fb1247973814582a3a4d9c1f2ca8ba8,
title = "Predictors of skeletal-related events and mortality in men with metastatic, castration-resistant prostate cancer: Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database",
abstract = "Background: Although skeletal-related events (SREs) are linked with a reduced quality of life and worse outcomes, to the authors' knowledge the factors that predict SREs are minimally understood. The objective of the current study was to identify predictors of SREs and all-cause mortality among men with metastatic castration-resistant prostate cancer (mCRPC). Methods: Data were collected on 837 men with bone mCRPC at 8 Veterans Affairs medical centers within the Shared Equal Access Regional Cancer Hospital (SEARCH) database from 2000 through 2017. Patients were followed to assess development of SREs (pathological fracture, radiotherapy to bone, spinal cord compression, or surgery to bone). Cox proportional hazards models were used to evaluate predictors of SREs and mortality. Results: Of the 837 men with bone mCRPC, 287 developed a SRE and 740 men died (median follow-up, 26 months). Bone pain was found to be the strongest predictor of SREs (hazard ratio [HR], 2.96; 95{\%} CI, 2.25-3.89). A shorter time from CRPC to the development of metastasis (HR, 0.92; 95{\%} CI, 0.85-0.99), shorter progression to CRPC (HR, 0.94; 95{\%} CI, 0.91-0.98), and visceral metastasis at the time of diagnosis of bone metastasis (HR, 1.91; 95{\%} CI, 1.18-3.09) were associated with an increased risk of SREs. Ten or more bone metastases (HR, 2.17; 95{\%} CI, 1.72-2.74), undergoing radical prostatectomy (HR, 0.73; 95{\%} CI, 0.61-0.89), shorter progression to CRPC (HR, 0.97; 95{\%} CI, 0.94-0.99), older age (HR, 1.03; 95{\%} CI, 1.02-1.04), higher prostate-specific antigen level at the time of diagnosis of metastasis (HR, 1.21; 95{\%} CI, 1.14-1.28), bone pain (HR, 1.44; 95{\%} CI, 1.23-1.70), and visceral metastasis (HR, 1.72; 95{\%} CI, 1.23-2.39) were associated with an increased mortality risk. Conclusions: Among men with bone mCRPC, bone pain was found to be the strongest predictor of SREs and the number of bone metastases was a strong predictor of mortality. If validated, these factors potentially may be used for risk stratification and for SRE prevention strategies.",
keywords = "Shared Equal Access Regional Cancer Hospital (SEARCH), bone, metastasis, predictors, prostate cancer, skeletal events",
author = "Tablazon, {Ingrid Lorese} and Howard, {Lauren E.} and {De Hoedt}, {Amanda M.} and Aronson, {William J.} and Kane, {Christopher J.} and Amling, {Christopher L.} and Cooperberg, {Matthew R.} and Terris, {Martha K.} and Freedland, {Stephen J.} and Williams, {Stephen B.}",
year = "2019",
month = "11",
day = "15",
doi = "10.1002/cncr.32414",
language = "English (US)",
volume = "125",
pages = "4003--4010",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "22",

}

TY - JOUR

T1 - Predictors of skeletal-related events and mortality in men with metastatic, castration-resistant prostate cancer

T2 - Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database

AU - Tablazon, Ingrid Lorese

AU - Howard, Lauren E.

AU - De Hoedt, Amanda M.

AU - Aronson, William J.

AU - Kane, Christopher J.

AU - Amling, Christopher L.

AU - Cooperberg, Matthew R.

AU - Terris, Martha K.

AU - Freedland, Stephen J.

AU - Williams, Stephen B.

PY - 2019/11/15

Y1 - 2019/11/15

N2 - Background: Although skeletal-related events (SREs) are linked with a reduced quality of life and worse outcomes, to the authors' knowledge the factors that predict SREs are minimally understood. The objective of the current study was to identify predictors of SREs and all-cause mortality among men with metastatic castration-resistant prostate cancer (mCRPC). Methods: Data were collected on 837 men with bone mCRPC at 8 Veterans Affairs medical centers within the Shared Equal Access Regional Cancer Hospital (SEARCH) database from 2000 through 2017. Patients were followed to assess development of SREs (pathological fracture, radiotherapy to bone, spinal cord compression, or surgery to bone). Cox proportional hazards models were used to evaluate predictors of SREs and mortality. Results: Of the 837 men with bone mCRPC, 287 developed a SRE and 740 men died (median follow-up, 26 months). Bone pain was found to be the strongest predictor of SREs (hazard ratio [HR], 2.96; 95% CI, 2.25-3.89). A shorter time from CRPC to the development of metastasis (HR, 0.92; 95% CI, 0.85-0.99), shorter progression to CRPC (HR, 0.94; 95% CI, 0.91-0.98), and visceral metastasis at the time of diagnosis of bone metastasis (HR, 1.91; 95% CI, 1.18-3.09) were associated with an increased risk of SREs. Ten or more bone metastases (HR, 2.17; 95% CI, 1.72-2.74), undergoing radical prostatectomy (HR, 0.73; 95% CI, 0.61-0.89), shorter progression to CRPC (HR, 0.97; 95% CI, 0.94-0.99), older age (HR, 1.03; 95% CI, 1.02-1.04), higher prostate-specific antigen level at the time of diagnosis of metastasis (HR, 1.21; 95% CI, 1.14-1.28), bone pain (HR, 1.44; 95% CI, 1.23-1.70), and visceral metastasis (HR, 1.72; 95% CI, 1.23-2.39) were associated with an increased mortality risk. Conclusions: Among men with bone mCRPC, bone pain was found to be the strongest predictor of SREs and the number of bone metastases was a strong predictor of mortality. If validated, these factors potentially may be used for risk stratification and for SRE prevention strategies.

AB - Background: Although skeletal-related events (SREs) are linked with a reduced quality of life and worse outcomes, to the authors' knowledge the factors that predict SREs are minimally understood. The objective of the current study was to identify predictors of SREs and all-cause mortality among men with metastatic castration-resistant prostate cancer (mCRPC). Methods: Data were collected on 837 men with bone mCRPC at 8 Veterans Affairs medical centers within the Shared Equal Access Regional Cancer Hospital (SEARCH) database from 2000 through 2017. Patients were followed to assess development of SREs (pathological fracture, radiotherapy to bone, spinal cord compression, or surgery to bone). Cox proportional hazards models were used to evaluate predictors of SREs and mortality. Results: Of the 837 men with bone mCRPC, 287 developed a SRE and 740 men died (median follow-up, 26 months). Bone pain was found to be the strongest predictor of SREs (hazard ratio [HR], 2.96; 95% CI, 2.25-3.89). A shorter time from CRPC to the development of metastasis (HR, 0.92; 95% CI, 0.85-0.99), shorter progression to CRPC (HR, 0.94; 95% CI, 0.91-0.98), and visceral metastasis at the time of diagnosis of bone metastasis (HR, 1.91; 95% CI, 1.18-3.09) were associated with an increased risk of SREs. Ten or more bone metastases (HR, 2.17; 95% CI, 1.72-2.74), undergoing radical prostatectomy (HR, 0.73; 95% CI, 0.61-0.89), shorter progression to CRPC (HR, 0.97; 95% CI, 0.94-0.99), older age (HR, 1.03; 95% CI, 1.02-1.04), higher prostate-specific antigen level at the time of diagnosis of metastasis (HR, 1.21; 95% CI, 1.14-1.28), bone pain (HR, 1.44; 95% CI, 1.23-1.70), and visceral metastasis (HR, 1.72; 95% CI, 1.23-2.39) were associated with an increased mortality risk. Conclusions: Among men with bone mCRPC, bone pain was found to be the strongest predictor of SREs and the number of bone metastases was a strong predictor of mortality. If validated, these factors potentially may be used for risk stratification and for SRE prevention strategies.

KW - Shared Equal Access Regional Cancer Hospital (SEARCH)

KW - bone

KW - metastasis

KW - predictors

KW - prostate cancer

KW - skeletal events

UR - http://www.scopus.com/inward/record.url?scp=85070665981&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070665981&partnerID=8YFLogxK

U2 - 10.1002/cncr.32414

DO - 10.1002/cncr.32414

M3 - Article

C2 - 31390061

AN - SCOPUS:85070665981

VL - 125

SP - 4003

EP - 4010

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 22

ER -