Treatment results and prognostic factors in advanced carcinoma of the prostate(stage D2)

Yoon, Jong Byung; Sung, Kyung Tak

Abstract

From January 1974 to December 1990, 54 patients with stage D2 carcinoma of the prostate. androgen deprivation therapy was initiated in 50 and no treatment in 4. The analyzed prognostic factors were age. urinary retention, bone pain, Karnofsky performance index. serum acid and alkaline phosphatase, anemia. Gleason`s sum, and EOD grading system (new EOD grade and EOD score). The 1. 3 and 5-year survival rates were 66.1 %, 40.1% and 21.6 %, respectively. Mean follow-up was 22 months ranging from 1 to 80 months. Evaluation of response to endocrine therapy in 42 evaluable patients based on NPCP criteria, 6 (15%) showed stabilization of disease with mean duration of 23 months, 8 (19%) partial response with mean duration of 28.4 months and 28 (66%) progression with mean duration of 12.1 months. Forty five patients with bone metastasis who received androgen deprivation therapy had their pretreatment bone scans reviewed using a semi-quantitative grading system based upon the extent of disease (EOD) observed on the bone scan. Using Soloway's 4 grade system, the survival of patients in categories between EOD grade 2 and S didn`t differ from each other. Based on Saitt new EOD 3 grade system, the survival in etch new EOD categories significantly differed from each other (p<0.05). When EOD score system was used employing ALP to overcome the false positive findings and inactive metastatic lesion. the mean survival of patients in EOD score system was improved from 59.8% to 60.4 %. Using the stepwise Cox regression procedure with 7 candidate factors. only two factors (anemia. EOD score) were statistically significant (p<0.1). We conclude anemia and EOD score are two most important prognosticators of the analyzed factors.