Impact of skeletal-related events on overall survival in patients with metastatic carcinoma of prostate receiving androgen deprivation therapy

Abstract

INTRODUCTION AND OBJECTIVES: To study the impact of skeletal-related events (SREs) on overall survival in patients with metastatic carcinoma of prostate receiving androgen deprivation therapy. METHODS: Patients with diagnosis of metastatic carcinoma of prostate and received hormonal therapy in terms of either bilateral orchidectomy or luteinizing hormone releasing hormone (LHRH) analogue injection from 2006 to 2011 in our hospital were reviewed. Demographic data, incidences of SREs and overall mortality were collected and analysed. RESULTS: There were in total 123 patients reviewed. The mean age at diagnosis was 75 years old. 58 patients had bilateral orchidectomy performed alone and 65 patients received LHRH analogue injection with 7 of them received subsequent bilateral orchidectomy. The SREs rate was 39.8% and overall mortality rate was 56.1%. The median follow up period was 21 months (Min: 1 month; Max: 125 months). Median time of survival for patients with SREs was significantly shorter than patients without SREs (25 vs 45 months, p =0.03). Timing of SREs after commencement of hormonal therapy (12 months) also have significant correlation to median survival (6 months vs 15 months, p =0.004) CONCLUSIONS: Occurrence and timing of SREs have significant correlation on median survival in patients with metastatic carcinoma of prostate. However, their causal relationships require further evaluation and elucidation. With such high prevalence of SREs and its impact on survival demonstrated in our study, every measure should be encouraged to minimize the incidence of SREs in this group of patient.