Long-term survival of extremely advanced prostate cancer patients diagnosed with prostate-specific antigen over 500 ng/ml

Toru Sugihara, Changhong Yu, Michael W. Kattan, Hideo Yasunaga, Hiroyuki Ihara, Mizuki Onozawa, Shiro Hinotsu, Hideyuki Akaza

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: To investigate survival of hormone-naïve prostate cancer patients diagnosed with prostate-specific antigen ≥500 ng/ml, stratified according to the prostate-specific antigen level and type of therapy. Methods: Data of prostate cancer patients with prostate-specific antigen ≥500 ng/ml diagnosed between 2001 and 2003 and receiving primary androgen deprivation therapy were extracted from the Japan Study Group of Prostate Cancer database. Cancer-specific survival and overall survival were assessed according to the prostate-specific antigen level (500-999, 1000-4999 and ≥5000 ng/ml) and type of therapy using Kaplan-Meier analyses and multivariate Cox proportional hazards models including age, Gleason score, oncological stage and comorbidity. Results: The median follow-up was 27 months (interquartile range, 13-51) and a total of 1961 patients were included. Five-year cancer-specific and overall mortalities were 39.0 and 33.0%, respectively. There was a significant inverse relationship between overall survival and prostatespecific antigen magnitude among combination therapy patients, but not monotherapy patients (log-rank test, P = 0.034 and 0.558, respectively). The median overall survival in combination therapy patients with low-, intermediate- and high prostate-specific antigen and monotherapy patients with any prostate-specific antigen were 79, 59, 45 and 43 months, respectively. Multivariate analysis showed that combination therapy in patients with low- and intermediate prostate-specific antigen was significantly associated with a favorable overall survival compared with monotherapy (hazard ratios 0.66 and 0.75, respectively, both P <0.001). Similar results were obtained for cancer-specific survival. Conclusions: There are major survival differences in extremely high prostate-specific antigen cases according to the prostate-specific antigen level and hormone therapy type and those patients would benefit notably from combination androgen blockade.

Original languageEnglish
Pages (from-to)1227-1232
Number of pages6
JournalJapanese Journal of Clinical Oncology
Volume44
Issue number12
DOIs
Publication statusPublished - Dec 1 2014

Fingerprint

Prostate-Specific Antigen
Prostatic Neoplasms
Survival
Therapeutics
Androgens
Hormones
Neoplasms
Neoplasm Grading
Kaplan-Meier Estimate
Proportional Hazards Models
Comorbidity
Japan
Multivariate Analysis
Databases
Antigens
Mortality

Keywords

  • Androgen antagonists
  • Neoplasm metastasis
  • Prostate neoplasms
  • Prostate-specific antigen
  • Survival analysis

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Long-term survival of extremely advanced prostate cancer patients diagnosed with prostate-specific antigen over 500 ng/ml. / Sugihara, Toru; Yu, Changhong; Kattan, Michael W.; Yasunaga, Hideo; Ihara, Hiroyuki; Onozawa, Mizuki; Hinotsu, Shiro; Akaza, Hideyuki.

In: Japanese Journal of Clinical Oncology, Vol. 44, No. 12, 01.12.2014, p. 1227-1232.

Research output: Contribution to journalArticle

Sugihara, T, Yu, C, Kattan, MW, Yasunaga, H, Ihara, H, Onozawa, M, Hinotsu, S & Akaza, H 2014, 'Long-term survival of extremely advanced prostate cancer patients diagnosed with prostate-specific antigen over 500 ng/ml', Japanese Journal of Clinical Oncology, vol. 44, no. 12, pp. 1227-1232. https://doi.org/10.1093/jjco/hyu142
Sugihara, Toru ; Yu, Changhong ; Kattan, Michael W. ; Yasunaga, Hideo ; Ihara, Hiroyuki ; Onozawa, Mizuki ; Hinotsu, Shiro ; Akaza, Hideyuki. / Long-term survival of extremely advanced prostate cancer patients diagnosed with prostate-specific antigen over 500 ng/ml. In: Japanese Journal of Clinical Oncology. 2014 ; Vol. 44, No. 12. pp. 1227-1232.
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abstract = "Objective: To investigate survival of hormone-na{\"i}ve prostate cancer patients diagnosed with prostate-specific antigen ≥500 ng/ml, stratified according to the prostate-specific antigen level and type of therapy. Methods: Data of prostate cancer patients with prostate-specific antigen ≥500 ng/ml diagnosed between 2001 and 2003 and receiving primary androgen deprivation therapy were extracted from the Japan Study Group of Prostate Cancer database. Cancer-specific survival and overall survival were assessed according to the prostate-specific antigen level (500-999, 1000-4999 and ≥5000 ng/ml) and type of therapy using Kaplan-Meier analyses and multivariate Cox proportional hazards models including age, Gleason score, oncological stage and comorbidity. Results: The median follow-up was 27 months (interquartile range, 13-51) and a total of 1961 patients were included. Five-year cancer-specific and overall mortalities were 39.0 and 33.0{\%}, respectively. There was a significant inverse relationship between overall survival and prostatespecific antigen magnitude among combination therapy patients, but not monotherapy patients (log-rank test, P = 0.034 and 0.558, respectively). The median overall survival in combination therapy patients with low-, intermediate- and high prostate-specific antigen and monotherapy patients with any prostate-specific antigen were 79, 59, 45 and 43 months, respectively. Multivariate analysis showed that combination therapy in patients with low- and intermediate prostate-specific antigen was significantly associated with a favorable overall survival compared with monotherapy (hazard ratios 0.66 and 0.75, respectively, both P <0.001). Similar results were obtained for cancer-specific survival. Conclusions: There are major survival differences in extremely high prostate-specific antigen cases according to the prostate-specific antigen level and hormone therapy type and those patients would benefit notably from combination androgen blockade.",
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AU - Sugihara, Toru

AU - Yu, Changhong

AU - Kattan, Michael W.

AU - Yasunaga, Hideo

AU - Ihara, Hiroyuki

AU - Onozawa, Mizuki

AU - Hinotsu, Shiro

AU - Akaza, Hideyuki

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AB - Objective: To investigate survival of hormone-naïve prostate cancer patients diagnosed with prostate-specific antigen ≥500 ng/ml, stratified according to the prostate-specific antigen level and type of therapy. Methods: Data of prostate cancer patients with prostate-specific antigen ≥500 ng/ml diagnosed between 2001 and 2003 and receiving primary androgen deprivation therapy were extracted from the Japan Study Group of Prostate Cancer database. Cancer-specific survival and overall survival were assessed according to the prostate-specific antigen level (500-999, 1000-4999 and ≥5000 ng/ml) and type of therapy using Kaplan-Meier analyses and multivariate Cox proportional hazards models including age, Gleason score, oncological stage and comorbidity. Results: The median follow-up was 27 months (interquartile range, 13-51) and a total of 1961 patients were included. Five-year cancer-specific and overall mortalities were 39.0 and 33.0%, respectively. There was a significant inverse relationship between overall survival and prostatespecific antigen magnitude among combination therapy patients, but not monotherapy patients (log-rank test, P = 0.034 and 0.558, respectively). The median overall survival in combination therapy patients with low-, intermediate- and high prostate-specific antigen and monotherapy patients with any prostate-specific antigen were 79, 59, 45 and 43 months, respectively. Multivariate analysis showed that combination therapy in patients with low- and intermediate prostate-specific antigen was significantly associated with a favorable overall survival compared with monotherapy (hazard ratios 0.66 and 0.75, respectively, both P <0.001). Similar results were obtained for cancer-specific survival. Conclusions: There are major survival differences in extremely high prostate-specific antigen cases according to the prostate-specific antigen level and hormone therapy type and those patients would benefit notably from combination androgen blockade.

KW - Androgen antagonists

KW - Neoplasm metastasis

KW - Prostate neoplasms

KW - Prostate-specific antigen

KW - Survival analysis

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