S&T-20 VALIDATION OF TNM CLASSIFICATION FOR METASTATIC PROSTATIC CANCER TREATED USING PRIMARY ANDROGEN DEPRIVATION THERAPY

Abstract

You have accessJournal of UrologyScience & Technology Posters1 Apr 2016S&T-20 VALIDATION OF TNM CLASSIFICATION FOR METASTATIC PROSTATIC CANCER TREATED USING PRIMARY ANDROGEN DEPRIVATION THERAPY Yoshifumi Kadono, Takahiro Nohara, Satoru Ueno, Kouji Izumi, Yasuhide Kitagawa, Hiroyuki Konaka, Atsushi Mizokami, Mizuki Onozawa, Shiro Hinotsu, Hideyuki Akaza, and Mikio Namiki Yoshifumi KadonoYoshifumi Kadono More articles by this author , Takahiro NoharaTakahiro Nohara More articles by this author , Satoru UenoSatoru Ueno More articles by this author , Kouji IzumiKouji Izumi More articles by this author , Yasuhide KitagawaYasuhide Kitagawa More articles by this author , Hiroyuki KonakaHiroyuki Konaka More articles by this author , Atsushi MizokamiAtsushi Mizokami More articles by this author , Mizuki OnozawaMizuki Onozawa More articles by this author , Shiro HinotsuShiro Hinotsu More articles by this author , Hideyuki AkazaHideyuki Akaza More articles by this author , and Mikio NamikiMikio Namiki More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2849AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The tumor-node-metastasis (TNM) classification system is used for the staging of malignant tumors. Although the TNM classification of metastatic prostate cancer (mPC) has not changed since 1992, no sufficient evaluation according to the mPC subcategory has been performed to date. The prognosis of patients with mPC treated using primary androgen deprivation therapy (PADT) was analyzed. METHODS A total of 5,618 cases with lymph node metastases only (N1M0), non-regional lymph node metastasis (M1a), bone metastasis (M1b), and distant metastasis (M1c) were selected from the Japanese Study Group of Prostate Cancer (J-CaP) database. Overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) rates were calculated using Kaplan-Meier analysis. The influence of clinical variables on patient prognosis was evaluated using the Coxs proportional hazard regression model. RESULTS Regarding age, patients with M1b tumors were significantly older than were those in the other groups. Prostate-specific antigen (PSA) levels tended to increase as the stage progressed. The Gleason score (GS) was significantly higher in the M1a group compared with the other groups. The 5-year OS was 76.0 % in the N1M0, 57.5 % in M1a, 54.0 % in M1b, and 40.0 % in M1c cases. The 5-year CSS was 83.2 % in the N1M0, 69.0 % in M1a, 63.1 % in M1b, and 51.5 % in M1c cases. The 5-year PFS was 38.8 % in the N1M0, 23.0 % in M1a, 23.0% in M1b, and 16.6 % in M1c cases. OS, CSS, and PFS declined as the stage progressed; however, there were no statistically significant differences between M1a and M1b cases. Among the patients in the M1b group, the 2,445 cases of N0M1b and the 1,607 cases of N1M1b were compared. OS, CSS and PFS were all significantly worse in N1M1b compared with N0M1b. In addition, there were no significant differences in OS and CSS not only between M1a and N0M1b, but also between N1M1b and M1c. Multivariate analysis revealed that OS and CSS were worse in patients with a GS ≥ 8, and that combined androgen blockade (CAB) treatment provided better OS than non-CAB treatments at any tumor stage. However, OS and CSS were worse in individuals with a PSA > 100 ng/ml only in M1b. CONCLUSIONS The prognosis worsened as the stage progressed, therefore, current TNM classification system of mPC for PADT was shown to be trustworthy; however, there were no significant differences in OS, CSS, and PFS between M1a and M1b disease. Each PC cell that develops bone metastasis or lymphoid metastasis may have different characteristics. CAB was more effective for the treatment of mPC than was non-CAB in our database. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e316 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Yoshifumi Kadono More articles by this author Takahiro Nohara More articles by this author Satoru Ueno More articles by this author Kouji Izumi More articles by this author Yasuhide Kitagawa More articles by this author Hiroyuki Konaka More articles by this author Atsushi Mizokami More articles by this author Mizuki Onozawa More articles by this author Shiro Hinotsu More articles by this author Hideyuki Akaza More articles by this author Mikio Namiki More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...