Prostate Cancer: Advanced IIModerated Poster764 LYMPH NODE POSITIVE PROSTATE CANCER: WHICH FACTORS PREDICT SURVIVAL?
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INTRODUCTION AND OBJECTIVES
The prognostic factors predicting survival in men with lymph node-positive prostate cancer are still poorly defined. We evaluated several tumor-related and host-related variables as potential predictors of survival in this population.
METHODS
193 patients treated between 1993 and 2005 were studied. The median follow-up in the censored patients was 7.3 years. 94 % of patients received immediate hormonal therapy. Kaplan-Meier curves were calculated to evaluate overall survival rates. Competing risk analyses were used to determine prostate cancer-specific and competing mortality. Cox proportional hazard models were used to determine the independent significance of prognostic variables.
RESULTS
Age (70 years or older versus younger, hazard ratio (HR) 3.0), Gleason score (8-10 versus 7 or lower, HR 3.2) and the number of involved nodes (3 or more versus 1-2, HR 2.0) were identified as independent prognostic factors. The excess mortality in patients with adverse prognostic factors was attributable both to prostate cancer and to competing mortality. Comorbidity was associated with mortality in univariate but not in multivariate analysis. PSA was without any detectable prognostic
CONCLUSIONS
A sizeable minority of narrowly one third of patients without additional adverse prognostic factors had an excellent long-term survival rate similar to that usually seen in patients with node-negative disease. Adverse comorbidity-related parameters seemed to shorten survival over-proportionally in patients with positive lymph nodes.
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