Predictors of Time to Metastasis in Castration-resistant Prostate Cancer

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

Research output: Contribution to journalArticle

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Abstract

Objective: To investigate predictors of time to metastasis among men treated with androgen deprivation therapy for nonmetastatic prostate cancer who developed castration-resistant prostate cancer (CRPC) within the Shared Equal Access Regional Cancer Hospital cohort. Methods: This is a retrospective analysis of 458 nonmetastatic CRPC men. Metastases were detected in routine bone scans or other imaging tests. Predictors of time to metastasis were analyzed using proportional hazards model with CRPC as time zero. Results: A total of 256 (56%) men were diagnosed with metastatic disease over a median follow-up of 36 months. Metastasis-free survival was 79%, 65%, 52%, 47%, and 41% at 1, 2, 3, 4, and 5 years after CRPC, respectively. In multivariable analysis, Gleason score 8-10 (hazard ratio [HR] = 1.61; . P = .026), receiving primary localized treatment (HR = 1.38; . P = .028), higher prostate-specific antigen (PSA) levels at CRPC diagnosis (logPSA HR = 1.64; . P <.001), and PSA doubling time ≤6 months (HR = 1.42; . P = .040) were independently associated with shorter time to metastasis. Race, year of CRPC, age, and time from androgen deprivation therapy to CRPC were not associated with metastasis. Conclusion: Among nonmetastatic CRPC men, nearly 60% developed metastatic disease during the first 5 years, with most of the metastasis occurring within the first 3 years. Higher Gleason score, receiving primary treatment, higher PSA, and shorter PSA doubling time were independently associated with shorter time to metastasis. Therefore, these variables can be used to stratify patients according to metastasis risk.

Original languageEnglish (US)
JournalUrology
DOIs
StateAccepted/In press - Feb 1 2016

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Castration
Prostatic Neoplasms
Neoplasm Metastasis
Prostate-Specific Antigen
Neoplasm Grading
Androgens
Cancer Care Facilities
Therapeutics
Proportional Hazards Models
Bone and Bones
Survival

ASJC Scopus subject areas

  • Urology

Cite this

Moreira, D. M., Howard, L. E., Sourbeer, K. N., Amarasekara, H. S., Chow, L. C., Cockrell, D. C., ... Freedland, S. J. (Accepted/In press). Predictors of Time to Metastasis in Castration-resistant Prostate Cancer. Urology. https://doi.org/10.1016/j.urology.2016.06.011

Predictors of Time to Metastasis in Castration-resistant Prostate Cancer. / Moreira, Daniel M.; Howard, Lauren E.; Sourbeer, Katharine N.; Amarasekara, Hiruni S.; Chow, Lydia C.; Cockrell, Dillon C.; Hanyok, Brian T.; Aronson, William J.; Kane, Christopher J.; Terris, Martha K.; Amling, Christopher; Cooperberg, Matthew R.; Liede, Alex; Freedland, Stephen J.

In: Urology, 01.02.2016.

Research output: Contribution to journalArticle

Moreira, DM, Howard, LE, Sourbeer, KN, Amarasekara, HS, Chow, LC, Cockrell, DC, Hanyok, BT, Aronson, WJ, Kane, CJ, Terris, MK, Amling, C, Cooperberg, MR, Liede, A & Freedland, SJ 2016, 'Predictors of Time to Metastasis in Castration-resistant Prostate Cancer', Urology. https://doi.org/10.1016/j.urology.2016.06.011
Moreira DM, Howard LE, Sourbeer KN, Amarasekara HS, Chow LC, Cockrell DC et al. Predictors of Time to Metastasis in Castration-resistant Prostate Cancer. Urology. 2016 Feb 1. https://doi.org/10.1016/j.urology.2016.06.011
Moreira, Daniel M. ; Howard, Lauren E. ; Sourbeer, Katharine N. ; Amarasekara, Hiruni S. ; Chow, Lydia C. ; Cockrell, Dillon C. ; Hanyok, Brian T. ; Aronson, William J. ; Kane, Christopher J. ; Terris, Martha K. ; Amling, Christopher ; Cooperberg, Matthew R. ; Liede, Alex ; Freedland, Stephen J. / Predictors of Time to Metastasis in Castration-resistant Prostate Cancer. In: Urology. 2016.
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abstract = "Objective: To investigate predictors of time to metastasis among men treated with androgen deprivation therapy for nonmetastatic prostate cancer who developed castration-resistant prostate cancer (CRPC) within the Shared Equal Access Regional Cancer Hospital cohort. Methods: This is a retrospective analysis of 458 nonmetastatic CRPC men. Metastases were detected in routine bone scans or other imaging tests. Predictors of time to metastasis were analyzed using proportional hazards model with CRPC as time zero. Results: A total of 256 (56{\%}) men were diagnosed with metastatic disease over a median follow-up of 36 months. Metastasis-free survival was 79{\%}, 65{\%}, 52{\%}, 47{\%}, and 41{\%} at 1, 2, 3, 4, and 5 years after CRPC, respectively. In multivariable analysis, Gleason score 8-10 (hazard ratio [HR] = 1.61; . P = .026), receiving primary localized treatment (HR = 1.38; . P = .028), higher prostate-specific antigen (PSA) levels at CRPC diagnosis (logPSA HR = 1.64; . P <.001), and PSA doubling time ≤6 months (HR = 1.42; . P = .040) were independently associated with shorter time to metastasis. Race, year of CRPC, age, and time from androgen deprivation therapy to CRPC were not associated with metastasis. Conclusion: Among nonmetastatic CRPC men, nearly 60{\%} developed metastatic disease during the first 5 years, with most of the metastasis occurring within the first 3 years. Higher Gleason score, receiving primary treatment, higher PSA, and shorter PSA doubling time were independently associated with shorter time to metastasis. Therefore, these variables can be used to stratify patients according to metastasis risk.",
author = "Moreira, {Daniel M.} and Howard, {Lauren E.} and Sourbeer, {Katharine N.} and Amarasekara, {Hiruni S.} and Chow, {Lydia C.} and Cockrell, {Dillon C.} and Hanyok, {Brian T.} and Aronson, {William J.} and Kane, {Christopher J.} and Terris, {Martha K.} and Christopher Amling and Cooperberg, {Matthew R.} and Alex Liede and Freedland, {Stephen J.}",
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T1 - Predictors of Time to Metastasis in Castration-resistant Prostate Cancer

AU - Moreira, Daniel M.

AU - Howard, Lauren E.

AU - Sourbeer, Katharine N.

AU - Amarasekara, Hiruni S.

AU - Chow, Lydia C.

AU - Cockrell, Dillon C.

AU - Hanyok, Brian T.

AU - Aronson, William J.

AU - Kane, Christopher J.

AU - Terris, Martha K.

AU - Amling, Christopher

AU - Cooperberg, Matthew R.

AU - Liede, Alex

AU - Freedland, Stephen J.

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Objective: To investigate predictors of time to metastasis among men treated with androgen deprivation therapy for nonmetastatic prostate cancer who developed castration-resistant prostate cancer (CRPC) within the Shared Equal Access Regional Cancer Hospital cohort. Methods: This is a retrospective analysis of 458 nonmetastatic CRPC men. Metastases were detected in routine bone scans or other imaging tests. Predictors of time to metastasis were analyzed using proportional hazards model with CRPC as time zero. Results: A total of 256 (56%) men were diagnosed with metastatic disease over a median follow-up of 36 months. Metastasis-free survival was 79%, 65%, 52%, 47%, and 41% at 1, 2, 3, 4, and 5 years after CRPC, respectively. In multivariable analysis, Gleason score 8-10 (hazard ratio [HR] = 1.61; . P = .026), receiving primary localized treatment (HR = 1.38; . P = .028), higher prostate-specific antigen (PSA) levels at CRPC diagnosis (logPSA HR = 1.64; . P <.001), and PSA doubling time ≤6 months (HR = 1.42; . P = .040) were independently associated with shorter time to metastasis. Race, year of CRPC, age, and time from androgen deprivation therapy to CRPC were not associated with metastasis. Conclusion: Among nonmetastatic CRPC men, nearly 60% developed metastatic disease during the first 5 years, with most of the metastasis occurring within the first 3 years. Higher Gleason score, receiving primary treatment, higher PSA, and shorter PSA doubling time were independently associated with shorter time to metastasis. Therefore, these variables can be used to stratify patients according to metastasis risk.

AB - Objective: To investigate predictors of time to metastasis among men treated with androgen deprivation therapy for nonmetastatic prostate cancer who developed castration-resistant prostate cancer (CRPC) within the Shared Equal Access Regional Cancer Hospital cohort. Methods: This is a retrospective analysis of 458 nonmetastatic CRPC men. Metastases were detected in routine bone scans or other imaging tests. Predictors of time to metastasis were analyzed using proportional hazards model with CRPC as time zero. Results: A total of 256 (56%) men were diagnosed with metastatic disease over a median follow-up of 36 months. Metastasis-free survival was 79%, 65%, 52%, 47%, and 41% at 1, 2, 3, 4, and 5 years after CRPC, respectively. In multivariable analysis, Gleason score 8-10 (hazard ratio [HR] = 1.61; . P = .026), receiving primary localized treatment (HR = 1.38; . P = .028), higher prostate-specific antigen (PSA) levels at CRPC diagnosis (logPSA HR = 1.64; . P <.001), and PSA doubling time ≤6 months (HR = 1.42; . P = .040) were independently associated with shorter time to metastasis. Race, year of CRPC, age, and time from androgen deprivation therapy to CRPC were not associated with metastasis. Conclusion: Among nonmetastatic CRPC men, nearly 60% developed metastatic disease during the first 5 years, with most of the metastasis occurring within the first 3 years. Higher Gleason score, receiving primary treatment, higher PSA, and shorter PSA doubling time were independently associated with shorter time to metastasis. Therefore, these variables can be used to stratify patients according to metastasis risk.

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