title: Survival and clinical metastases among prostate cancer patients treated with androgen deprivation therapy in Sweden.
abstract: OBJECTIVE
  To examine the incidence of metastases and clinical course of prostate cancer patients who are without confirmed metastasis when initiating androgen deprivation therapy (ADT).
  
  
  METHODS
  Retrospective cohort study conducted using electronic medical records from Swedish outpatient urology clinics linked to national mandatory registries to capture medical and demographic data. Prostate cancer patients initiating ADT between 2000 and 2010 were followed from initiation of ADT to metastasis, death, and/or end of follow-up.
  
  
  RESULTS
  The 5-year cumulative incidence (CI) of metastasis was 18%. Survival was 60% after 5 years; results were similar for bone metastasis-free survival. The 5-year CI of castration-resistant prostate cancer (CRPC) was 50% and the median survival from CRPC development was 2.7 years. Serum prostate-specific antigen (PSA) levels and PSA doubling time were strong predictors of bone metastasis, any metastasis, and death.
  
  
  CONCLUSIONS
  This study provides understanding of the clinical course of prostate cancer patients without confirmed metastasis treated with ADT in Sweden. Greater PSA values and shorter PSA doubling time (particularly ≤ 6 months) were associated with increased risk of bone metastasis, any metastasis, and death.
authors.affiliation: Quantify Research, Hantverkargatan 8, 112 21 Stockholm, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Banefelt
authors.affiliation: Amgen Inc., Center for Observational Research, South San Francisco, CA, United States.
authors.forename: A
authors.initials: A
authors.lastname: Liede
authors.affiliation: Quantify Research, Hantverkargatan 8, 112 21 Stockholm, Sweden; Institute of Environmental Medicine, Karolinska Institute, 171 77 Stockholm, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Mesterton
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, 751 22 Uppsala, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Stålhammar
authors.affiliation: Amgen Inc., Center for Observational Research, One Amgen Center Drive 24-2-A, Thousand Oaks, CA 91320, United States.
authors.forename: R K
authors.initials: RK
authors.lastname: Hernandez
authors.affiliation: IMS Health/Pygargus, Sveavägen 155, 113 46 Stockholm, Sweden; LIME/Medical Management Centre, Karolinska Institute, 171 77 Stockholm, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Sobocki
authors.affiliation: Uppsala University, 751 05 Uppsala, Sweden. Electronic address: Bo-Eric.Persson@ferring.com.
authors.forename: B-E
authors.initials: BE
authors.lastname: Persson
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D015331:Cohort Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology*; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology*; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D017430:Prostate-Specific Antigen
keywords: ADT; CRPC; Metastasis; PSA; Prostate cancer