MP53-15 LOCAL THERAPY IN METASTATIC PROSTATE CANCER: DOES THE BURDEN OF DISEASE MATTER? RESULTS FROM A NATIONAL POPULATION-BASED CANCER REGISTRY

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) III1 Apr 2017MP53-15 LOCAL THERAPY IN METASTATIC PROSTATE CANCER: DOES THE BURDEN OF DISEASE MATTER? RESULTS FROM A NATIONAL POPULATION-BASED CANCER REGISTRY Vivek Venkatramani, Tulay Koru-Sengul, Feng Miao, Bruno Nahar, Nachiketh Soodana Prakash, Mahmoud Alameddine, Sanjaya Swain, Chad Ritch, Mark Gonzalgo, Dipen Parekh, and Sanoj Punnen Vivek VenkatramaniVivek Venkatramani More articles by this author , Tulay Koru-SengulTulay Koru-Sengul More articles by this author , Feng MiaoFeng Miao More articles by this author , Bruno NaharBruno Nahar More articles by this author , Nachiketh Soodana PrakashNachiketh Soodana Prakash More articles by this author , Mahmoud AlameddineMahmoud Alameddine More articles by this author , Sanjaya SwainSanjaya Swain More articles by this author , Chad RitchChad Ritch More articles by this author , Mark GonzalgoMark Gonzalgo More articles by this author , Dipen ParekhDipen Parekh More articles by this author , and Sanoj PunnenSanoj Punnen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1666AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent studies have shown a possible survival advantage for men with metastatic prostate cancer (MPCa) who undergo local treatment of the primary tumor in addition androgen deprivation therapy (ADT) when compared to ADT alone. We hypothesize that this benefit will depend on the degree of metastatic burden. We assess this by looking at men with varying levels of metastatic disease, and comparing the overall survival (OS) between those who did and did not undergo local therapy in addition to ADT. METHODS Patients with MPCa (cN+ or cM+) who received ADT were identified from the National Cancer Database (NCDB) (2004-2013). We categorized men based on the extent of metastatic disease (NIM0, M1a, m1b and M1c). Within each group we modeled the propensity to receive local therapy to the primary. We then compared those undergoing local therapy in addition to ADT to those undergoing ADT alone in a 1:1 propensity matched analysis. Kaplan-Meir curves and Cox proportional Hazards regression were used to compare overall survival (OS) in men receiving local therapy with ADT to ADT alone within each metastatic category. RESULTS A total of 17,950 men with MPCa who received ADT were identified. Of these, 1,109 received local treatment and 16,841 did not. After propensity matching we had 1876 patients in the N1M0 group, 76 patients in the M1a group, 244 patients in the M1b group and 12 patients in the M1c group, with an even distribution of men between the two treatment groups in each metastatic category. Survival was not analyzed in the M1c group due to the low number. We found that there was a significant benefit in OS for men underging local therapy in all other sub-groups (Figure 1). Cox regression analysis revealed a benefit from local therapy in all analyzed groups: N1M0: HR=0.56, 95%CI 0.47-0.67, p<0.001, M1a: HR=0.3, 95%CI 0.12-0.73, p=0.008, M1b: HR=0.54, 95%CI 0.38-0.77, p<0.001. CONCLUSIONS CONCLUSIONS: Our study shows a significant benefit in OS for men with MPCa undergoing local therapy in addition to ADT, versus ADT alone in men with N1M0-M1b prostate cancer. These results require further validation, ideally via prospective randomized trials. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e719 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Vivek Venkatramani More articles by this author Tulay Koru-Sengul More articles by this author Feng Miao More articles by this author Bruno Nahar More articles by this author Nachiketh Soodana Prakash More articles by this author Mahmoud Alameddine More articles by this author Sanjaya Swain More articles by this author Chad Ritch More articles by this author Mark Gonzalgo More articles by this author Dipen Parekh More articles by this author Sanoj Punnen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...