Three-year interim results of overall and progression-free survival in a cohort of patients with prostate cancer (GESCAP group)

Actas Urol Esp (Engl Ed). 2019 Jan-Feb;43(1):4-11. doi: 10.1016/j.acuro.2018.03.004. Epub 2018 Jun 8.
[Article in English, Spanish]

Abstract

Aims: To describe the 3-year progression-free survival (PFS), overall survival (OS) and disease-specific mortality in the prospective prostate cancer GESCAP cohort, as well as the progression to castration resistance in patients on hormone therapy.

Material and methods: Prospective, observational, epidemiological, multicentre study. Of the 4087 patients recruited, 3843 were evaluable. The variables analysed were the risk group (localized, locally advanced, lymph involvement, metastatic), age, prostate-specific antigen (PSA) levels, Gleason score and initial treatment. Kaplan Meier survival analysis, the log-rank test and the Cox model were used to evaluate the survival data.

Results: Three-year PFS was 81.4% and OS was 92.4%. During the 3 years of follow-up, 303 patients died (7.9%), 110 of them (36.3%) due to disease-related causes. The probability of castration resistance for all patients on hormone therapy (n=715) was 14.2%: 5%, 9.9%, 26.1% and 44.4% in localized, locally advanced, lymph involvement and metastatic cancer, respectively (log-rank P<.0001). Patients with metastases had poorer outcomes with respect to PFS, OS, disease-specific mortality and castration resistance. In the multivariate analysis, the Gleason score, PSA and presence of metastases were associated with shorter OS and PFS.

Conclusions: Our study showed stratification of risk, with a more unfavourable prognosis for patients with metastases. Patients with locally advanced disease differed with respect to those with localized disease due to their higher risk as regards disease-specific mortality. (Controlled-trials.com ISRCTN19893319).

Keywords: Castration resistance; Cáncer de próstata; Metastasis; Metástasis; Progresión; Progression; Prostate cancer; Resistencia a la castración; Supervivencia; Survival.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adenocarcinoma / epidemiology*
  • Adenocarcinoma / therapy
  • Aged
  • Combined Modality Therapy
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Progression-Free Survival
  • Proportional Hazards Models
  • Prospective Studies
  • Prostatic Neoplasms / epidemiology*
  • Prostatic Neoplasms / therapy
  • Prostatic Neoplasms, Castration-Resistant / epidemiology
  • Prostatic Neoplasms, Castration-Resistant / therapy
  • Risk
  • Spain / epidemiology
  • Treatment Outcome

Associated data

  • ISRCTN/ISRCTN19893319