Clinical characteristics and quality-of-life in patients surviving a decade of prostate cancer with bone metastases

OBJECTIVE: To describe characteristics and quality-of-life (QOL) and to define factors associated with long-term survival in a subgroup of prostate cancer patients with M1b disease.

METHODS AND PATIENTS: 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 (TAB). Long-term survival was defined as patients having an overall survival >10 year, and logistic regression models were constructed to identity clinical predictors of survival. QOL during follow-up was assessed using EROTC-30 ratings. .

RESULTS: Forty (4.4%) of the 915 men survived longer than 10 years. Factors significantly associated with increased likelihood of surviving more than ten years in the univariate analyses were: absence of cancer-related pain; performance status < 2; negligible analgesic consumption; T-category 1-2; PSA <231 μg/L; and a Soloway score 1. In the multivariate analyses, performance status < 2, PSA < 231 μg/L, and Soloway score 1, were all independent predictors of long-term survival. All subscales of EORTC-C30 were higher in this group than for patients with short survival, but slowly declined over the decade.

CONCLUSION: A subgroup of prostate cancer patients with M1b disease and certain characteristics showed a positive long-term response to ADT with an acceptable QOL over a decade or more. Independent predictors of long-term survival were identified as performance status < 2, limited extent of bone metastases (Soloway score 1), and a PSA level < 231 μg/L at the time of enrolment. This article is protected by copyright. All rights reserved.