Skeletal Related Events, Bone Metastasis and Survival of Prostate Cancer: A Population Based Cohort Study in Denmark (1999 to 2007)

被引:288
作者
Norgaard, Mette
Jensen, Annette Ostergaard [1 ]
Jacobsen, Jacob Bonde
Cetin, Kara [2 ]
Fryzek, Jon P. [2 ]
Sorensen, Henrik Toft
机构
[1] Aarhus Univ Hosp, Dept Clin Epidemiol, Aarhus, Denmark
[2] Amgen Inc, Global Epidemiol, Thousand Oaks, CA 91320 USA
关键词
prostate; prostatic neoplasms; neoplasm metastasis; bone and bones; prognosis; COMPLICATIONS; MORBIDITY; CORRELATE; IMPACT;
D O I
10.1016/j.juro.2010.03.034
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: We describe mortality in patients with prostate cancer with and without bone metastasis further characterized by skeletal related events. Materials and Methods: We performed a cohort study of 23,087 incident patients with prostate cancer with a median 2.2-year followup identified through the Danish National Patient Registry from 1999 to 2007. We estimated the cumulative incidence of bone metastasis and skeletal related events, and described survival using the Kaplan-Meier method. Based on a Cox proportional hazard model we estimated mortality rate ratios and associated 95% CIs comparing mortality rates between patients by bone metastasis with and without skeletal related events, adjusting for age and comorbidity. Results: Of the patients 569 (almost 3%) presented with bone metastasis at prostate cancer diagnosis, of whom 248 (43.6%) experienced a skeletal related event during followup. Of the 22,404 men (97% overall) without bone metastasis at diagnosis 2,578 (11.5%) were diagnosed with bone metastasis and 1,329 (5.9%) also experienced a skeletal related event during followup. One and 5-year survival was 87% and 56% in patients with prostate cancer without bone metastasis, 47% and 3% in those with bone metastasis, and 40% and less than 1% in those with bone metastasis and skeletal related events, respectively. Compared with men with prostate cancer without bone metastasis the adjusted 1-year mortality rate ratio was 4.7 (95% CI 4.3-5.2) in those with bone metastasis and no skeletal related events, and 6.6 (95% CI 5.9-7.5) in those with bone metastasis and a skeletal related event. Conclusions: Bone metastasis and skeletal related events predict poor prognosis in men with prostate cancer.
引用
收藏
页码:162 / 167
页数:6
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