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Factors predicting skeletal-related events in patients with bone metastatic castration-resistant prostate cancer.

Publication ,  Journal Article
Klaassen, Z; Howard, LE; de Hoedt, A; Amling, CL; Aronson, WJ; Cooperberg, MR; Kane, CJ; Terris, MK; Freedland, SJ
Published in: Cancer
May 2017

Skeletal-related events (SREs) are common complications of bone metastatic castration-resistant prostate cancer (mCRPC). To the authors' knowledge, there are limited data regarding which factors predict SREs. The authors identified risk factors for SREs in men with bone mCRPC using characteristics commonly available in the medical record.Data from 454 patients with nonmetastatic CRPC were identified from 2 Veteran Affairs Medical Centers from 2000 through 2013. Among these men, 233 (51%) developed bone metastases during follow-up and represented the study cohort. First occurrence of an SRE was abstracted from the medical records. A stepwise multivariable Cox model was used to select the strongest predictors of time to SRE.The median age of the patients at the time of diagnosis of bone mCRPC was 75 years (interquartile range, 68-81 years), and there were 153 nonblack patients (66%). During follow-up (median, 7.8 months [interquartile range, 2.9-18.3 months]), 88 patients (38%) had an SRE. On univariable analysis, more recent year of metastasis (hazard ratio [HR], 0.91), prostate-specific antigen doubling time of ≥9 months versus <9 months (HR, 0.50), and bone pain (HR, 3.34) were all found to be associated with SRE risk. On multivariable analysis, year of metastasis (HR, 0.93), biopsy Gleason score of 7 versus ≤6 (HR, 1.74), radiotherapy as the primary localized treatment versus none (HR, 2.33), and bone pain (HR, 3.64) were associated with SRE risk. The area under the curve for a multivariable model based upon these risk factors was 0.744.The authors identified several significant predictors of SREs among men with mCRPC. In particular, men with bone pain are at high risk of an SRE. If confirmed, future trials should focus on prolonging life and reducing SRE risk in patients with mCRPC with bone pain. Cancer 2017;123:1528-1535. © 2017 American Cancer Society.

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Published In

Cancer

DOI

EISSN

1097-0142

ISSN

0008-543X

Publication Date

May 2017

Volume

123

Issue

9

Start / End Page

1528 / 1535

Related Subject Headings

  • Spinal Cord Compression
  • Risk Factors
  • Retrospective Studies
  • Radiotherapy
  • Prostatic Neoplasms, Castration-Resistant
  • Prostate-Specific Antigen
  • Proportional Hazards Models
  • Pain
  • Orthopedic Procedures
  • Oncology & Carcinogenesis
 

Citation

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Klaassen, Z., Howard, L. E., de Hoedt, A., Amling, C. L., Aronson, W. J., Cooperberg, M. R., … Freedland, S. J. (2017). Factors predicting skeletal-related events in patients with bone metastatic castration-resistant prostate cancer. Cancer, 123(9), 1528–1535. https://doi.org/10.1002/cncr.30505
Klaassen, Zachary, Lauren E. Howard, Amanda de Hoedt, Christopher L. Amling, William J. Aronson, Matthew R. Cooperberg, Christopher J. Kane, Martha K. Terris, and Stephen J. Freedland. “Factors predicting skeletal-related events in patients with bone metastatic castration-resistant prostate cancer.Cancer 123, no. 9 (May 2017): 1528–35. https://doi.org/10.1002/cncr.30505.
Klaassen Z, Howard LE, de Hoedt A, Amling CL, Aronson WJ, Cooperberg MR, et al. Factors predicting skeletal-related events in patients with bone metastatic castration-resistant prostate cancer. Cancer. 2017 May;123(9):1528–35.
Klaassen, Zachary, et al. “Factors predicting skeletal-related events in patients with bone metastatic castration-resistant prostate cancer.Cancer, vol. 123, no. 9, May 2017, pp. 1528–35. Epmc, doi:10.1002/cncr.30505.
Klaassen Z, Howard LE, de Hoedt A, Amling CL, Aronson WJ, Cooperberg MR, Kane CJ, Terris MK, Freedland SJ. Factors predicting skeletal-related events in patients with bone metastatic castration-resistant prostate cancer. Cancer. 2017 May;123(9):1528–1535.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

ISSN

0008-543X

Publication Date

May 2017

Volume

123

Issue

9

Start / End Page

1528 / 1535

Related Subject Headings

  • Spinal Cord Compression
  • Risk Factors
  • Retrospective Studies
  • Radiotherapy
  • Prostatic Neoplasms, Castration-Resistant
  • Prostate-Specific Antigen
  • Proportional Hazards Models
  • Pain
  • Orthopedic Procedures
  • Oncology & Carcinogenesis