Improvement in overall and cancer-specific survival in contemporary, metastatic prostate cancer chemotherapy exposed patients
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Improvement in overall and cancer-specific survival in contemporary, metastatic prostate cancer chemotherapy exposed patients. / Hoeh, Benedikt; Würnschimmel, Christoph; Flammia, Rocco S; Horlemann, Benedikt; Sorce, Gabriele; Chierigo, Francesco; Tian, Zhe; Saad, Fred; Graefen, Markus; Gallucci, Michele; Briganti, Alberto; Terrone, Carlo; Shariat, Shahrokh F; Tilki, Derya; Kluth, Luis A; Mandel, Philipp; Chun, Felix K H; Karakiewicz, Pierre I.
in: PROSTATE, Jahrgang 81, Nr. 16, 12.2021, S. 1374-1381.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Improvement in overall and cancer-specific survival in contemporary, metastatic prostate cancer chemotherapy exposed patients
AU - Hoeh, Benedikt
AU - Würnschimmel, Christoph
AU - Flammia, Rocco S
AU - Horlemann, Benedikt
AU - Sorce, Gabriele
AU - Chierigo, Francesco
AU - Tian, Zhe
AU - Saad, Fred
AU - Graefen, Markus
AU - Gallucci, Michele
AU - Briganti, Alberto
AU - Terrone, Carlo
AU - Shariat, Shahrokh F
AU - Tilki, Derya
AU - Kluth, Luis A
AU - Mandel, Philipp
AU - Chun, Felix K H
AU - Karakiewicz, Pierre I
N1 - © 2021 The Authors. The Prostate published by Wiley Periodicals LLC.
PY - 2021/12
Y1 - 2021/12
N2 - INTRODUCTION: 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.MATERIALS AND METHODS: 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.RESULTS: 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).CONCLUSIONS: In mPCa patients, chemotherapy rates increased over time. A concomitant increase in survival was also recorded.
AB - INTRODUCTION: 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.MATERIALS AND METHODS: 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.RESULTS: 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).CONCLUSIONS: In mPCa patients, chemotherapy rates increased over time. A concomitant increase in survival was also recorded.
U2 - 10.1002/pros.24235
DO - 10.1002/pros.24235
M3 - SCORING: Journal article
C2 - 34523162
VL - 81
SP - 1374
EP - 1381
JO - PROSTATE
JF - PROSTATE
SN - 0270-4137
IS - 16
ER -
