Skeletal fractures negatively correlate with overall survival in men with prostate cancer.
OBJECTIVE
We assessed the correlation of skeletal fracture with survival in men with prostate cancer on chronic androgen suppressive therapy.


METHODS
A total of 195 consecutive patients on chronic androgen suppression for prostate cancer were evaluated for the history and type of skeletal fracture. Correlation with overall survival was performed via multivariate analysis.


RESULTS
Of these 195 men 24 reported skeletal fracture since the diagnosis of prostate cancer. Median overall survival was 121 and 160 months in men without and with a history of skeletal fracture since the diagnosis of prostate cancer, respectively (p = 0.04). A history of skeletal fracture was retained as a negative predictor of survival on forward stepwise regression analysis (RR = 7.4, p = 0.007).


CONCLUSIONS
Our results suggest that skeletal fracture in patients with prostate cancer is an independent and adverse predictor of survival. Consideration for screening men at greatest risk via bone mineral density measurements and initiating empirical skeletal therapies (bisphosphonates, estrogens and so forth) may be warranted. This recommendation awaits validation through prospective randomized trials.
Department of Urology, University Hospitals of Cleveland, Case Western Reserve School of Medicine, Cleveland, Ohio, USA.
Michael G
MG
Oefelein
Vincent
V
Ricchiuti
William
W
Conrad
Martin I
MI
Resnick
D000230:Adenocarcinoma / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D005598:Fractures, Spontaneous / Q000139:chemically induced / Q000150:complications*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000139:chemically induced; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D012307:Risk Factors; D015996:Survival Rate
D000726:Androgen Antagonists