title: Clinical characteristics and quality-of-life in patients surviving a decade of prostate cancer with bone metastases.
abstract: To describe characteristics and quality-of-life (QoL), and to define factors associated with long-term survival in a subgroup of patients with prostate cancer with M1b disease.
  
  
  
  The study was based on 915 patients from a prospective randomised multicentre trial (No. 5) by the Scandinavian Prostate Cancer Group, comparing parenteral oestrogen with total androgen blockade. Long-term survival was defined as patients having an overall survival of ≥10 years, and logistic regression models were constructed to identity clinical predictors of survival. QoL during follow-up was assessed using the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire - C30 version 1 (EORTC-C30) ratings.
  
  
  
  In all, 40 (4.4%) of the 915 men survived for >10 years. Factors significantly associated with increased likelihood of surviving for >10 years in the univariate analyses were: absence of cancer-related pain; Eastern Cooperative Oncology Group (ECOG) performance status of <2; negligible analgesic consumption; T-category of 1-2; prostate-specific antigen (PSA) level of <231 μg/L; and a Soloway score of 1. In the multivariate analyses, ECOG performance status of <2, PSA level of <231 μg/L, and Soloway score of 1, were all independent predictors of long-term survival. All subscales of the EORTC-C30 were higher in this group than for patients with short survival, but slowly declined over the decade.
  
  
  
  A subgroup of patients with prostate cancer with M1b disease and certain characteristics showed a positive long-term response to androgen-deprivation therapy with an acceptable QoL over a decade or more. Independent predictors of long-term survival were identified as ECOG performance status of <2, limited extent of bone metastases (Soloway score of 1), and a PSA level of <231 μg/L at the time of enrolment.
authors.affiliation: Department of Urology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: Rami
authors.initials: R
authors.lastname: Klaff
authors.affiliation: Eksätravägen 72, Uppsala, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Berglund
authors.affiliation: Department of Urology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: Eberhard
authors.initials: E
authors.lastname: Varenhorst
authors.affiliation: Department of Urology, Karolinska Institute Solna, Solna, Sweden.
authors.forename: Per Olov
authors.initials: PO
authors.lastname: Hedlund
authors.affiliation: Department of Urology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Jǿnler
authors.affiliation: Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Hospital Huddinge, Huddinge, Sweden.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Sandblom
mesh_terms: D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000097:blood / Q000556:secondary* / Q000628:therapy; D004958:Estradiol / Q000031:analogs & derivatives / Q000627:therapeutic use; D004967:Estrogens / Q000627:therapeutic use; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology* / Q000628:therapy; D011788:Quality of Life; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D018931:Antineoplastic Agents, Hormonal; D004967:Estrogens; D004958:Estradiol; D017430:Prostate-Specific Antigen; C008958:polyestradiol phosphate
keywords: bone metastases; long-term survival; prostate cancer; quality-of-life