Management and characteristics of patients with metastatic prostate cancer in a cohort of New Zealand men

Oncology. 2015;88(3):157-63. doi: 10.1159/000368319. Epub 2014 Nov 15.

Abstract

Objective: This study aims to (1) characterise men diagnosed with metastatic prostate cancer, (2) describe their management and (3) look at their survival.

Methods: We identified patients registered with prostate cancer in the New Zealand Cancer Registry in the Midland Cancer Network region in 2009-2012 and examined these patients' clinical records to identify the metastatic cases. We investigated the patients' characteristics and the treatment pattern. All-cause survival was estimated by the Cox proportional hazards model.

Results: Of the 2,127 men diagnosed with prostate cancer, 234 (26 Maori/Pacific and 208 non-Maori/non-Pacific) were diagnosed with metastatic prostate cancer. After the diagnosis, 194 (82.9%) patients received androgen deprivation therapy (ADT), 5 had chemotherapy and 104 (44.4%) had radiotherapy. Of the patients treated with ADT, 46 (23.7%) had no monitoring prostate-specific antigen tests. Fifty-nine percent of the patients were alive after 12 months and 35% after 24 months. The hazard ratio for the Maori/Pacific men was 1.49.

Conclusion: Overall, the survival of patients with metastatic prostate cancer was poor. There seems to be a strong case for the development of New Zealand guidelines on the management of metastatic disease including the use of first-line treatments, the ongoing monitoring for the development of castration-resistant prostate cancer (CRPC) and the treatment of CRPC.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Cohort Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Metastasis / drug therapy*
  • Neoplasm Metastasis / pathology
  • New Zealand / ethnology
  • Prostate-Specific Antigen / analysis
  • Prostatic Neoplasms / drug therapy*
  • Prostatic Neoplasms / mortality*
  • Prostatic Neoplasms / pathology
  • Survival Analysis
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Hormonal
  • Prostate-Specific Antigen