title: Characterizations of Clinical and Therapeutic Histories for Men With Prostate Cancer-Specific Mortality.
abstract: BACKGROUND
  Careful descriptions of men with prostate cancer (PCa)-specific mortality are scant in nontrial settings. The present retrospective review describes the clinical characteristics, timelines, and treatment histories from initial presentation to death in a cohort of men with metastatic, castrate-resistant PCa (mCRPC). Unique to the present study is the unequivocal attribution of PCa death by a single experienced clinician.
  
  
  METHODS
  A total of 119 patients who had been treated at Tulane Cancer Center and had died of mCRPC from 2008 to 2015 were studied through a retrospective review of the medical records.
  
  
  RESULTS
  The median age at diagnosis was 65 years (range, 40-85 years), and 34.4% of the patients presented with metastatic disease (stage M1). Of these patients, 56% had received definitive primary therapy, all had received androgen-deprivation therapy, and 52% had received docetaxel. The patients had received a median of 7 (1-14) systemic therapies before death. Most were secondary hormonal manipulations after the diagnosis of mCRPC (median, 4; range, 0-9). The median survival was 69 months (range, 5-270 months) after diagnosis, and the median age at death was 73 years (range, 47-95 years). The presence of metastases at diagnosis was a significant predictor of early death (hazard ratio, 4.33; P < .001), and definitive primary therapy was a significant predictor of longer survival (P < .001). The median survival for patients presenting with metastases was 39 months (range, 5-235 months) compared with 100 months (range, 6-270 months) for those with localized disease (P < .001). The median age at diagnosis between the docetaxel- and non-docetaxel-treated patients was significantly different at 62 and 71 years, respectively (P = .002).
  
  
  CONCLUSIONS
  The present retrospective analysis provides initial views clarifying the clinical characteristics of men dying of mCRPC and the therapies they received before death. Additional data are needed in multi-institutional settings to confirm these findings.
authors.affiliation: Tulane University School of Medicine, New Orleans, LA.
authors.forename: Allie E
authors.initials: AE
authors.lastname: Steinberger
authors.affiliation: Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Elisa M
authors.initials: EM
authors.lastname: Ledet
authors.affiliation: Department of Internal Medicine, University of Massachusetts Medical School, Worcester, MA.
authors.forename: Eric
authors.initials: E
authors.lastname: Luk
authors.affiliation: Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Cotogno
authors.affiliation: Tulane University School of Medicine, New Orleans, LA.
authors.forename: Michael
authors.initials: M
authors.lastname: Stolten
authors.affiliation: Tulane University School of Medicine, New Orleans, LA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Desmond
authors.affiliation: Department of Urology, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Allison
authors.initials: A
authors.lastname: Feibus
authors.affiliation: Department of Urology, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Silberstein
authors.affiliation: Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA; Departments of Medicine and Urology, Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA. Electronic address: osartor@tulane.edu.
authors.forename: Oliver
authors.initials: O
authors.lastname: Sartor
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016016:Proportional Hazards Models; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Castrate-resistant; Longitudinal; Metastatic; Mortality; Prostate cancer