Chronic pulmonary disease negatively influences the prognosis of patients with advanced prostate cancer.
OBJECTIVE
We examined the prognostic value of chronic pulmonary disease (CPD), which can cause hypoxemic hypoxia possibly resulting in tumor hypoxia, in patients with advanced prostate cancer (APC).


METHODS
We evaluated 295 patients with APC who had initially received androgen deprivation therapy. The progression to hormone refractory prostate cancer (HRPC), and the overall and disease specific survival were analyzed; the relationship to clinicopathological variables, including the presence of CPD, result of pulmonary function tests (PFT), smoking history and hemoglobin level were evaluated by the Kaplan-Meier method. A multivariate analysis was then performed according to the Cox regression model.


RESULTS
The median time to HRPC was 14 and 38 months in patients with and without CPD, respectively (P = 0.001). The median overall survival from diagnosis was 51 and 81 months (P = 0.007), and the median disease specific survival was 56 and 135 months, respectively (P = 0.008). A univariate analysis showed that the result of PFT was a significant variable for progression to HRPC. In addition, the hemoglobin level (11.4 g/dl, 25th percentile) was a significant variable for overall and disease specific survival. As a result of the multivariate analysis, the presence of CPD was an independent prognostic variable for progression to HRPC, as were the Gleason score and stage. As well, CPD was an independent prognostic variable for overall and disease specific survival, as were alkaline phosphatase levels and nadir PSA.


CONCLUSIONS
Our findings strongly implicate CPD as a factor that contributes to a poor prognosis in patients with APC.
Jeong
Chang Wook
CW
Department of Urology, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, South Korea.
Ku
Ja Hyeon
JH
Kwak
Cheol
C
Kim
Hyeon Hoe
HH
Lee
Sang Eun
SE
D000230:Adenocarcinoma / Q000150:complications* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D018450:Disease Progression; D006801:Humans; D008171:Lung Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate