title: Ten-year survival in patients with metastatic prostate cancer.
abstract: The objective of this analysis is to identify baseline covariates that predict which patients will be long-term survivors with metastatic prostate cancer. We analyzed data from Southwest Oncology Group (SWOG) S8894, a clinical trial in men with newly diagnosed metastatic prostate cancer, to evaluate pretreatment characteristics associated with 10-year survival. There were 1286 eligible patients randomized to this study. Of these, 794 have been followed for > or = 10.5 years and are included in the analyses. Proportional odds models were used to predict 3 survival categories (survival for < 5 years, 5 up to 10 years, and > or = 10 years). Baseline patient and disease characteristics investigated were protocol treatment (flutamide vs. placebo), severity of disease, SWOG performance status (PS), bone pain, Gleason score, race, age, and prostate-specific antigen (PSA) level at study entry. Of the 794 evaluable patients, 77% lived < 5 years, 16% lived 5 up to 10 years, and 7% lived > or = 10 years. Factors predicting a statistical significant association with longer survival (P < 0.05) included minimal disease, better PS, no bone pain, lower Gleason score, and lower PSA level. All but PS were also significant in multivariate analyses. However, only 13% of patients (5 of 38) who lived > or = 10 years were correctly predicted in their survival category based on the model, whereas 98% (405 of 414) who died within the first 5 years were correctly predicted. Although statistically significant baseline characteristics were identified in this clinical trial, they did not accurately predict the survival interval to which a patient belonged.
authors.affiliation: The Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA. cathyt@crab.org
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Tangen
authors.forename: James R
authors.initials: JR
authors.lastname: Faulkner
authors.forename: E David
authors.initials: ED
authors.lastname: Crawford
authors.forename: Ian M
authors.initials: IM
authors.lastname: Thompson
authors.forename: Daisaku
authors.initials: D
authors.lastname: Hirano
authors.forename: Mario
authors.initials: M
authors.lastname: Eisenberger
authors.forename: Maha
authors.initials: M
authors.lastname: Hussain
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000556:secondary* / Q000628:therapy*; D000368:Aged; D000726:Androgen Antagonists / Q000008:administration & dosage; D018572:Disease-Free Survival; D004311:Double-Blind Method; D005485:Flutamide / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009919:Orchiectomy / Q000379:methods*; D011336:Probability; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D005485:Flutamide; D017430:Prostate-Specific Antigen