Impact of Cerebrovascular Disease on Survival Benefits from Local Treatment in Patients with De Novo Metastatic Hormone-Sensitive Prostate Cancer

Local treatment has become a treatment option for patients with de novo metastatic hormone-sensitive prostate cancer (mHSPC). Subgroup analyses based on a history of cerebrovascular disease (CVD) were performed to evaluate the impact thereof on overall survival (OS) after local treatment. A retrospe...

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Bibliographic Details
Published in:Yonsei medical journal 2019, 60(12), , pp.1129-1137
Main Authors: Kim, Tae Jin, Yu, Young Dong, Park, Dong Soo, Rha, Koon Ho, Hong, Sung Joon, Cho, Kang Su, Chung, Byung Ha, Koo, Kyo Chul
Format: Article
Language:English
Subjects:
Aged
Androgens - pharmacology
Cerebrovascular Disorders - complications
Cohort Studies
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Metastasis
Original
Proportional Hazards Models
Prospective Studies
Prostatic Neoplasms - pathology
Prostatic Neoplasms - therapy
Retrospective Studies
Risk Factors
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Summary:Local treatment has become a treatment option for patients with de novo metastatic hormone-sensitive prostate cancer (mHSPC). Subgroup analyses based on a history of cerebrovascular disease (CVD) were performed to evaluate the impact thereof on overall survival (OS) after local treatment. A retrospective analysis was performed for 879 patients with de novo mHSPC between August 2003 and November 2016. Patients were stratified according to prior CVD history and the type of initial treatment: androgen-deprivation therapy (ADT) alone versus local treatment consisting of radical prostatectomy (RP) or radiation therapy (RT) with ADT, with or without metastasis-directed therapy. The primary outcome was OS assessed by Kaplan-Meier analysis and Cox-regression models. Of 879 patients, 660 (75.1%) men underwent ADT alone, and 219 (24.9%) men underwent RP or RT with ADT, with or without metastasis-directed therapy. The median follow-up was 38 months. Multivariable analysis showed CVD history to be associated with a higher risk of overall mortality ( =0.001). In the overall cohort and in patients without a history of CVD, patients who underwent local treatment exhibited higher OS than men who received ADT alone (all
ISSN:0513-5796
1976-2437
DOI:10.3349/ymj.2019.60.12.1129