Improvement in overall and cancer-specific survival in contemporary, metastatic prostate cancer chemotherapy exposed patients.
Adenocarcinoma
/ drug therapy
Antineoplastic Combined Chemotherapy Protocols
/ administration & dosage
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Mortality
/ trends
Neoplasm Metastasis
/ diagnosis
Neoplasm Staging
Prognosis
Proportional Hazards Models
Prostate-Specific Antigen
/ analysis
Prostatic Neoplasms
/ drug therapy
Risk Assessment
/ methods
SEER Program
/ statistics & numerical data
chemotherapy
contemporary
metastatic prostate cancer
survival
Journal
The Prostate
ISSN: 1097-0045
Titre abrégé: Prostate
Pays: United States
ID NLM: 8101368
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
revised:
02
08
2021
received:
03
07
2021
accepted:
30
08
2021
pubmed:
16
9
2021
medline:
22
2
2022
entrez:
15
9
2021
Statut:
ppublish
Résumé
Over the last decade, multiple clinical trials demonstrated improved survival after chemotherapy for metastatic prostate cancer (mPCa). However, real-world data validating this effect within large-scale epidemiological data sets are scarce. We addressed this void. Men with de novo mPCa were identified and systemic chemotherapy status was ascertained within the Surveillance, Epidemiology, and End Results database (2004-2016). Patients were divided between historical (2004-2013) versus contemporary (2014-2016). Chemotherapy rates were plotted over time. Kaplan-Meier plots and Cox regression models with additional multivariable adjustments addressed overall and cancer-specific mortality. All tests were repeated in propensity-matched analyses. Overall, 19,913 patients had de novo mPCa between 2004 and 2016. Of those, 1838 patients received chemotherapy. Of 1838 chemotherapy-exposed patients, 903 were historical, whereas 905 were contemporary. Chemotherapy rates increased from 5% to 25% over time. Median overall survival was not reached in contemporary patients versus was 24 months in historical patients (hazard ratio [HR]: 0.55, p < 0.001). After propensity score matching and additional multivariable adjustment (age, prostate-specific antigen, GGG, cT-stage, cN-stage, cM-stage, and local treatment) a HR of 0.55 (p < 0.001) was recorded. Analyses were repeated for cancer-specific mortality after adjustment for other cause mortality in competing risks regression models and recorded virtually the same findings before and after propensity score matching (HR: 0.55, p < 0.001). In mPCa patients, chemotherapy rates increased over time. A concomitant increase in survival was also recorded.
Substances chimiques
Prostate-Specific Antigen
EC 3.4.21.77
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1374-1381Informations de copyright
© 2021 The Authors. The Prostate published by Wiley Periodicals LLC.
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