Prognostic Factors Affecting Progression and Survival in Metastatic Prostate CancerNayyar R. · Sharma N. · Gupta N.P.
Department of Urology, All India Institute of Medical Sciences, New Delhi, India
Purpose: To evaluate the role of age, Gleason score, prostate-specific antigen (PSA), PSA doubling time (PSADT), and PSA half-time (PSAT1/2) as prognostic factors in metastatic prostate cancer to predict long-term outcome. Patients and Methods: 412 patients with metastatic prostate cancer diagnosed after January 1995, with at least 6 months of follow-up, were enrolled. Serum PSA was determined at diagnosis and every 3–6 months thereafter. All patients underwent medical or surgical castration. End points of the study were either death or disease progression. Univariate and multivariate Cox proportional hazard analysis was used to evaluate prognostic factors. Results: Median progression-free and overall survival was 3 and 5.7 years. Patients aged ≤65 years at diagnosis, high baseline PSA and high nadir PSA were associated with poor overall survival. Patients with a PSAT1/2 of <6 months, high baseline alkaline phosphatase, and PSADT of <1 month had significantly poorer progression-free and overall survival. Conclusion: Prostate cancer is a common malignancy in the elderly population. We have found that younger patients with high baseline and nadir PSA, shorter PSADT and PSAT1/2 have poorer overall and progression-free survival.
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