Improved Overall Survival Trends of Men with Newly Diagnosed M1 Prostate Cancer: A SWOG Phase III Trial Experience (S8494, S8894 and S9346)

被引：84

作者：

Tangen, Catherine M. ^{[1
]}

Hussain, Maha H. A. ^{[3
]}

Higano, Celestia S. ^{[2
]}

Eisenberger, Mario A. ^{[5
]}

Small, Eric J. ^{[6
]}

Wilding, George ^{[7
]}

Donnelly, Bryan J. ^{[8
]}

Schelhammer, Paul F. ^{[9
]}

Crawford, E. David ^{[10
]}

Vogelzang, Nicholas J. ^{[11
]}

Powell, Isaac J. ^{[4
]}

Thompson, Ian M., Jr. ^{[12
]}

机构：

[1] Fred Hutchinson Canc Res Ctr, SWOG Stat Ctr, Seattle, WA 98109 USA

[2] Univ Washington, Seattle, WA 98195 USA

[3] Univ Michigan, Ann Arbor, MI 48109 USA

[4] Wayne State Univ, Detroit, MI USA

[5] Johns Hopkins Univ, Sch Med, Johns Hopkins Oncol Ctr, Baltimore, MD 21205 USA

[6] Univ Calif San Francisco, San Francisco, CA 94143 USA

[7] Univ Wisconsin, Madison, WI USA

[8] Tom Baker Canc Clin, Calgary, AB, Canada

[9] Eastern Virginia Urol Canc Outreach Program, Norfolk, VA USA

[10] Univ Colorado, Denver, CO 80202 USA

[11] Comprehens Canc Ctr Nevada, Las Vegas, NV USA

[12] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA

来源：

JOURNAL OF UROLOGY | 2012年 / 188卷 / 04期

关键词：

prostate; prostatic neoplasms; neoplasm metastasis; mortality; prostate-specific antigen; PLUS FLUTAMIDE; MORTALITY; ORCHIECTOMY;

D O I：

10.1016/j.juro.2012.06.046

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Purpose: Frequent prostate specific antigen testing for screening and monitoring prostate cancer has led to significant stage migration. We evaluated whether overall survival in hormone nave patients with metastatic prostate cancer has improved during the era of prostate specific antigen use. We also assessed whether any patient subsets benefited differentially during this period. Materials and Methods: We compared overall survival in 3 sequential phase III trials of 3,096 men with hormone nave, metastatic prostate cancer who received similar androgen deprivation therapy, including 2 trials performed before the prostate specific antigen era (S8494 and S8894) and the other done during this era (S9346). Overall survival was adjusted for patient and disease risk factors in the latter 2 trials. Subgroups were evaluated by interactions of risk factors with trial. Results: Median overall survival was 30 months in S8494, 33 months in S8894 and 49 months in S9346. Adjusting for risk factors, there was a 22% lower risk of death in S9346 than in S8894 (HR 0.78, 95% CI 0.70, 0.87, p <0.001). The improvement in overall survival was greater in black American men ( test of interaction p = 0.008). In S8494 and S8894 median survival for black men was 27 months, and 34 and 35 months for nonblack men, respectively. This racial difference disappeared in S9346 with overall survival of 48 and 49 months in black and nonblack men, respectively. Conclusions: Adjusting for risk factors, overall survival was significantly improved in the post-prostate specific antigen era trial. However, it cannot be concluded that this was attributable only to prostate specific antigen monitoring. Black men now have overall survival comparable to that of white men. Current estimates of survival should be used to design new trials in this population.

引用

页码：1164 / 1169

页数：6