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Prognostic model of event-free survival for patients with androgen-independent prostate carcinoma.

AbstractBACKGROUND:
The current study was conducted to develop a prognostic model of event-free survival (EFS) in men with androgen-independent prostate carcinoma (AIPC).
METHODS:
Data from 160 patients diagnosed with AIPC between 1989-2002 were reviewed. No patient had received cytotoxic chemotherapy. A univariate Cox proportional hazards model identified significant predictors of EFS. Recursive partitioning analysis divided these significant variables into prognostic risk groups. The final prognostic model was tested with a Cox proportional hazards model.
RESULTS:
The final prognostic risk model included the presence of metastatic disease at the time of androgen-independent disease progression (P = 0.040), time to prostate-specific antigen (PSA) recurrence (P = 0.043), and PSA doubling time (P < 0.01). Three highly independent risk groups were identified. The observed median EFSs were 6.1 months (95% confidence interval [95= CI], 3.4-8.8 months), 33.6 months (95= CI, 25.3-41.9 months), and 96.1 months (95= CI, 57.9-134.3 months) for the low-risk, intermediate-risk, and high-risk groups, respectively. Each risk group was found to be independently predictive of EFS (P < 0.01). Patients who died of prostate carcinoma experienced significantly more clinical events than those who died of other causes (P < 0.01).
CONCLUSIONS:
The prognostic model in the current study stratified patients into three highly significant and independent risk groups for EFS. A detailed PSA history and knowledge of metastatic disease are sufficient to risk-stratify patients with AIPC. One very unique aspect of this model was that it was developed from a patient cohort that never received chemotherapy.
AuthorsMichael J Shulman, Elie A Benaim
JournalCancer (Cancer) Vol. 103 Issue 11 Pg. 2280-6 (Jun 01 2005) ISSN: 0008-543X [Print] United States
PMID15844202 (Publication Type: Journal Article)
Chemical References
  • Androgens
  • Prostate-Specific Antigen
Topics
  • Aged
  • Aged, 80 and over
  • Androgens (therapeutic use)
  • Cohort Studies
  • Disease Progression
  • Disease-Free Survival
  • Humans
  • Male
  • Middle Aged
  • Models, Biological
  • Neoplasm Staging
  • Neoplasms, Hormone-Dependent (diagnosis, mortality, therapy)
  • Prognosis
  • Prostate-Specific Antigen (metabolism)
  • Prostatectomy
  • Prostatic Neoplasms (diagnosis, mortality, therapy)
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Treatment Outcome

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