Predicting Time From Metastasis to Overall Survival in Castration-Resistant Prostate Cancer: Results From SEARCH.
To identify the predictors of time from initial diagnosis of metastatic castration-resistance prostate cancer (mCRPC) to all-cause death within the Shared Equal Access Regional Cancer Hospital cohort.



We performed a retrospective analysis of 205 mCRPC men. Overall survival was estimated and plotted using the Kaplan-Meier method. The uni- and multivariable overall survival predictors were evaluated with the Cox proportional hazards model. A nomogram was generated to predict overall survival at 1, 2, 3, and 5 years after mCRPC. Concordance index and calibration plot were obtained.



A total of 170 men (83%) died over a median follow-up of 41 months. In univariable analysis, older age, more remote year of mCRPC, nonblack race, greater number of bone metastasis, higher prostate-specific antigen (PSA) levels, shorter PSA doubling time, and faster PSA velocity at mCRPC diagnosis were significantly associated with shorter overall survival (all P < .05). In multivariable analysis, older age, more remote year of mCRPC, greater number of bone metastasis, higher PSA levels, and shorter PSA doubling time at mCRPC diagnosis remained significantly associated with shorter overall survival (all P < .05). On the basis of these variables, a nomogram was generated yielding a concordance index of 0.67 and good calibration.



The use of clinical parameter such as age, disease burden, and PSA levels and kinetics can be used to estimate overall survival in mCRPC patients.
Department of Urology, University of Illinois at Chicago, Chicago, IL. Electronic address: moreira@uic.edu.
Daniel M
DM
Moreira
Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC; Urology Section, Veterans Affairs Medical Center, Durham, NC; Division of Urology, Department of Surgery, and the Duke Prostate Center, Duke University School of Medicine, Durham, NC.
Lauren E
LE
Howard
Urology Section, Veterans Affairs Medical Center, Durham, NC; Division of Urology, Department of Surgery, and the Duke Prostate Center, Duke University School of Medicine, Durham, NC.
Katharine N
KN
Sourbeer
Urology Section, Veterans Affairs Medical Center, Durham, NC; Division of Urology, Department of Surgery, and the Duke Prostate Center, Duke University School of Medicine, Durham, NC.
Hiruni S
HS
Amarasekara
Urology Section, Veterans Affairs Medical Center, Durham, NC; Division of Urology, Department of Surgery, and the Duke Prostate Center, Duke University School of Medicine, Durham, NC.
Lydia C
LC
Chow
Urology Section, Veterans Affairs Medical Center, Durham, NC; Division of Urology, Department of Surgery, and the Duke Prostate Center, Duke University School of Medicine, Durham, NC.
Dillon C
DC
Cockrell
Urology Section, Veterans Affairs Medical Center, Durham, NC; Division of Urology, Department of Surgery, and the Duke Prostate Center, Duke University School of Medicine, Durham, NC.
Connor L
CL
Pratson
Urology Section, Veterans Affairs Medical Center, Durham, NC; Division of Urology, Department of Surgery, and the Duke Prostate Center, Duke University School of Medicine, Durham, NC.
Brian T
BT
Hanyok
Urology Section, Department of Surgery, Veterans Affairs Medical Center, Greater Los Angeles, Los Angeles, CA; Department of Urology, University of California at Los Angeles Medical Center, Los Angeles, CA.
William J
WJ
Aronson
Division of Urology, Department of Surgery, University of California at San Diego Medical Center, San Diego, CA.
Christopher J
CJ
Kane
Urology Section, Division of Surgery, Veterans Affairs Medical Centers and Division of Urologic Surgery, Department of Surgery, Medical College of Georgia, Augusta, GA.
Martha K
MK
Terris
Division of Urology, Department of Surgery, Oregon Health and Science University, Portland, OR.
Christopher L
CL
Amling
Departments of Urology and Epidemiology and Biostatistics, University of California, San Francisco and Urology Section, Department of Surgery, Veterans Affairs Medical Center, San Francisco, CA.
Matthew R
MR
Cooperberg
Urology Section, Veterans Affairs Medical Center, Durham, NC; Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.
Stephen J
SJ
Freedland
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D017052:Hospital Mortality; D006787:Hospitals, Veterans; D006801:Humans; D007610:Kallikreins / Q000378:metabolism; D008297:Male; D009362:Neoplasm Metastasis; D049451:Nomograms; D017430:Prostate-Specific Antigen / Q000378:metabolism; D064129:Prostatic Neoplasms, Castration-Resistant / Q000378:metabolism / Q000401:mortality*; D012189:Retrospective Studies; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology
C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
Disease-free survival; Mortality; Prostate cancer; Prostate-specific antigen; Prostatectomy
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