Approach to the Treatment of Metastatic Castration-Sensitive Prostate Carcinoma: A Single Center Experience

Year 2022, , 296 - 304, 27.01.2022

Hüseyin Salih Semiz , Merve Keskinkılıç , Halil İbrahim Ellez , Mehmet Emin Arayıcı , Aziz Karaoglu

https://doi.org/10.30621/jbachs.1057317

Cited By: 2

Abstract

Objective: Prostate cancer is the the second common cancer in men in Turkey. We aimed to share our single center experience on the characteristics of patients with metastatic castration sensitive prostate cancer (mCSPC) and the factors affecting survival.
Materials and Methods: Between January 2007 and December 2020, 280 patients (aged 18 years and older men) who applied with the diagnosis of metastatic prostate carcinoma were screened in this retrospective cross-sectional study. Sociodemographic and clinicopathological characteristics of the patients were obtained retrospectively from the hospital database. The study variables of the research were included descriptive characteristics of the patients, metastasis sites, treatments, comorbidities of the patients and overal survival were evaluated. For the statistical analysis, descriptive statistics, Chi-Square Test, Fisher Exact Test, Kaplan Meier and Cox Regression model were used as appropriate.
Results: A total of 201 patient who applied with the diagnosis of mCSPC were included in this study. The median age of the patients at the time of diagnosis was 68.67 years (43,97-90,48), 43.56% (n=88) of the patients were ≥ 70 years old and 56.43% (n=114) were under 70 years of age. The median follow-up time was 55.5 months, and the median overall survival was found to be 34.93 months (27.90-41.96). 34.7% of the patients were still alive at the time of date cut-off. The median overall survival of the patients was found to be significantly lower in individuals ≥70 years old than under 70 years of age (p=0.032). According to the LATITUDE study the median overall survival of the high-risk group (26.56 months) was statistically significantly lower than in the low-risk group (44.83 months). When the patients were evaluated in terms of disease volume according to CHAARTED, it was found that the median overall survival of the patient group with high-volume disease (29.03 months) was statistically significantly lower than the group with low-volume disease (46.80 months) (p=0.001).
Conclusion: In this study, it was shown that being over 70 years old, a low BMI, high volume disease defined as in the CHAARTED trial, and high risk disease defined as in the LATITUDE trial had a negative impact on survival of patients with mCSPC.

Keywords

prostat cancer, survival, castration, elderly

References

• 1. Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Allen C, et al. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study [published correction appears in JAMA Oncol. 2017 Mar 1;3(3):418]. JAMA Oncol. 2017;3(4):524-548. doi:10.1001/jamaoncol.2016.5688
• 2. Viale PH. The American Cancer Society's Facts & Figures: 2020 Edition. J Adv Pract Oncol.2020;11(2):135-136.doi:10.6004/jadpro.2020.11.2.1. The Global Cancer Observatory - March, 2021.
• 3. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: Turkey Fact Sheets. Avaliable from: https://efaidnbmnnnibpcajpcglclefindmkaj/viewer.htmlpdfurl=https%3A%2F%2Fgco.iarc.fr%2Ftoday%2Fdata%2Ffactsheets%2Fpopulations%2F792-turkey-fact-sheets.pdf&clen=340028&chunk=true. Accessed on 12 JAN 2022.
• 4. National Comprehensive Cancer Network. Prostate Cancer (Version 2.2022). http://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf
• 5. Zorlu F, Zorlu R, Divrik RT, Eser S, Yorukoglu K. Prostate cancer incidence in Turkey: an epidemiological study. Asian Pac J Cancer Prev. 2014;15(21):9125-9130. doi:10.7314/apjcp.2014.15.21.9125.
• 6. Jefferson M, Drake RR, Lilly M, Savage SJ, Tucker Price S, Hughes Halbert C. Co-morbidities in a Retrospective Cohort of Prostate Cancer Patients. Ethn Dis. 2020;30(Suppl 1):185-192. Published 2020 Apr 2. doi:10.18865/ed.30.S1.185
• 7. Kasivisvanathan V, Rannikko AS, Borghi M, et al. MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis. N Engl J Med. 2018;378(19):1767-1777. doi:10.1056/NEJMoa1801993
• 8. Epstein JI, Zelefsky MJ, Sjoberg DD, et al. A Contemporary Prostate Cancer Grading System: A Validated Alternative to the Gleason Score. Eur Urol. 2016;69(3):428-435. doi:10.1016/j.eururo.2015.06.046
• 9. Shah N, Ioffe V. Frequency of Gleason score 7 to 10 in 5100 elderly prostate cancer patients. Rev Urol. 2016;18(4):181-187. doi:10.3909/riu0732
• 10. Huang JF, Shen J, Li X, et al. Incidence of patients with bone metastases at diagnosis of solid tumors in adults: a large population-based study. Ann Transl Med. 2020;8(7):482. doi:10.21037/atm.2020.03.55
• 11. Weiner AB, Cohen JE, DeLancey JO, Schaeffer EM, Auffenberg GB. Surgical versus Medical Castration for Metastatic Prostate Cancer: Use and Overall Survival in a National Cohort. J Urol. 2020;203(5):933-939.doi:10.1097/JU.0000000000000684
• 12. Smith MR, Halabi S, Ryan CJ, et al. Randomized controlled trial of early zoledronic acid in men with castration-sensitive prostate cancer and bone metastases: results of CALGB 90202 (alliance). J Clin Oncol. 2014;32(11):1143-1150. doi:10.1200/JCO.2013.51.6500
• 13. Borno HT, Lichtensztajn DY, Gomez SL, Palmer NR, Ryan CJ. Differential use of medical versus surgical androgen deprivation therapy for patients with metastatic prostate cancer. Cancer. 2019;125(3):453-462. doi:10.1002/cncr.31826
• 14. George DJ, Sartor O, Miller K, et al. Treatment Patterns and Outcomes in Patients With Metastatic Castration-resistant Prostate Cancer in a Real-world Clinical Practice Setting in the United States. Clin Genitourin Cancer. 2020;18(4):284-294. doi:10.1016/j.clgc.2019.12.019
• 15. Gravis G, Fizazi K, Joly F, et al. Androgen-deprivation therapy alone or with docetaxel in non-castrate metastatic prostate cancer (GETUG-AFU 15): a randomised, open-label, phase 3 trial. Lancet Oncol. 2013;14(2):149-158. doi:10.1016/S1470-2045(12)70560-0
• 16. James ND, Sydes MR, Clarke NW, et al. Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial. Lancet. 2016;387(10024):1163-1177. doi:10.1016/S0140-6736(15)01037-5
• 17. Sweeney CJ, Chen YH, Carducci M, et al. Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer. N Engl J Med. 2015;373(8):737-746. doi:10.1056/NEJMoa1503747
• 18. Cao Y, Ma J. Body mass index, prostate cancer-specific mortality, and biochemical recurrence: a systematic review and meta-analysis. Cancer Prev Res (Phila). 2011;4(4):486-501. doi:10.1158/1940-6207.CAPR-10-0229
• 19. Bleyer A, Spreafico F, Barr R. Prostate cancer in young men: An emerging young adult and older adolescent challenge. Cancer. 2020;126(1):46-57. doi:10.1002/cncr.32498
• 20. Siegel DA, O'Neil ME, Richards TB, Dowling NF, Weir HK. Prostate Cancer Incidence and Survival, by Stage and Race/Ethnicity - United States, 2001-2017. MMWR Morb Mortal Wkly Rep. 2020;69(41):1473-1480. Published 2020 Oct 16. doi:10.15585/mmwr.mm6941a1
• 21. Fizazi K, Tran N, Fein L, et al. Abiraterone plus Prednisone in Metastatic, Castration-Sensitive Prostate Cancer. N Engl J Med. 2017;377(4):352-360. doi:10.1056/NEJMoa1704174
• 22. Kawahara T, Yoneyama S, Ohno Y, et al. Prognostic Value of the LATITUDE and CHAARTED Risk Criteria for Predicting the Survival of Men with Bone Metastatic Hormone-Naïve Prostate Cancer Treated with Combined Androgen Blockade Therapy: Real-World Data from a Japanese Multi-Institutional Study. Biomed Res Int. 2020;2020:7804932. Published 2020 Jul 1. doi:10.1155/2020/7804932
• 23. Kawahara T, Yoneyama S, Ohno Y, et al. Prognostic Value of the LATITUDE and CHAARTED Risk Criteria for Predicting the Survival of Men with Bone Metastatic Hormone-Naïve Prostate Cancer Treated with Combined Androgen Blockade Therapy: Real-World Data from a Japanese Multi-Institutional Study. Biomed Res Int. 2020;2020:7804932. Published 2020 Jul 1. doi:10.1155/2020/7804932