Approach to the Treatment of Metastatic Castration-Sensitive Prostate Carcinoma: A Single Center Experience

Authors : Hüseyin Salih Semiz, Merve Keskinkiliç, Halil Ibrahim Ellez, Mehmet Emin Arayici, Aziz Karaoglu

Pages : 296-304

Doi:10.30621/jbachs.1057317

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Publication Date : 2022-01-27

Article Type : Research

Abstract :Objective: Prostate cancer is the the second common cancer in men in Turkey. We aimed to share our single center experience on the characteristics of patients with metastatic castration sensitive prostate cancer (mCSPC) and the factors affecting survival. Materials and Methods: Between January 2007 and December 2020, 280 patients (aged 18 years and older men) who applied with the diagnosis of metastatic prostate carcinoma were screened in this retrospective cross-sectional study. Sociodemographic and clinicopathological characteristics of the patients were obtained retrospectively from the hospital database. The study variables of the research were included descriptive characteristics of the patients, metastasis sites, treatments, comorbidities of the patients and overal survival were evaluated. For the statistical analysis, descriptive statistics, Chi-Square Test, Fisher Exact Test, Kaplan Meier and Cox Regression model were used as appropriate. Results: A total of 201 patient who applied with the diagnosis of mCSPC were included in this study. The median age of the patients at the time of diagnosis was 68.67 years (43,97-90,48), 43.56% (n=88) of the patients were ≥ 70 years old and 56.43% (n=114) were under 70 years of age. The median follow-up time was 55.5 months, and the median overall survival was found to be 34.93 months (27.90-41.96). 34.7% of the patients were still alive at the time of date cut-off. The median overall survival of the patients was found to be significantly lower in individuals ≥70 years old than under 70 years of age (p=0.032). According to the LATITUDE study the median overall survival of the high-risk group (26.56 months) was statistically significantly lower than in the low-risk group (44.83 months). When the patients were evaluated in terms of disease volume according to CHAARTED, it was found that the median overall survival of the patient group with high-volume disease (29.03 months) was statistically significantly lower than the group with low-volume disease (46.80 months) (p=0.001). Conclusion: In this study, it was shown that being over 70 years old, a low BMI, high volume disease defined as in the CHAARTED trial, and high risk disease defined as in the LATITUDE trial had a negative impact on survival of patients with mCSPC.
Keywords : prostat cancer, survival, castration, elderly