TY  - JOUR
A1  - Höh, Robert Benedikt
A1  - Würnschimmel, Christoph
A1  - Flammia, Rocco Simone
A1  - Horlemann, Benedikt
A1  - Sorce, Gabriele
A1  - Chierigo, Francesco
A1  - Tian, Zhe
A1  - Saad, Fred
A1  - Graefen, Markus
A1  - Gallucci, Michele
A1  - Briganti, Alberto
A1  - Terrone, Carlo
A1  - Shariat, Shahrokh F.
A1  - Tilki, Derya
A1  - Kluth, Luis
A1  - Mandel, Philipp
A1  - Chun, Felix
A1  - Karakiewicz, Pierre I.
T1  - Improvement in overall and cancer-specific survival in contemporary, metastatic prostate cancer chemotherapy exposed patients
T2  - The prostate
N2  - Introduction: Over the last decade, multiple clinical trials demonstrated improved survival after chemotherapy for metastatic prostate cancer (mPCa). However, real-world data validating this effect within large-scale epidemiological data sets are scarce. We addressed this void. Materials and Methods: Men with de novo mPCa were identified and systemic chemotherapy status was ascertained within the Surveillance, Epidemiology, and End Results database (2004–2016). Patients were divided between historical (2004–2013) versus contemporary (2014–2016). Chemotherapy rates were plotted over time. Kaplan–Meier plots and Cox regression models with additional multivariable adjustments addressed overall and cancer-specific mortality. All tests were repeated in propensity-matched analyses. Results: Overall, 19,913 patients had de novo mPCa between 2004 and 2016. Of those, 1838 patients received chemotherapy. Of 1838 chemotherapy-exposed patients, 903 were historical, whereas 905 were contemporary. Chemotherapy rates increased from 5% to 25% over time. Median overall survival was not reached in contemporary patients versus was 24 months in historical patients (hazard ratio [HR]: 0.55, p < 0.001). After propensity score matching and additional multivariable adjustment (age, prostate-specific antigen, GGG, cT-stage, cN-stage, cM-stage, and local treatment) a HR of 0.55 (p < 0.001) was recorded. Analyses were repeated for cancer-specific mortality after adjustment for other cause mortality in competing risks regression models and recorded virtually the same findings before and after propensity score matching (HR: 0.55, p < 0.001). Conclusions: In mPCa patients, chemotherapy rates increased over time. A concomitant increase in survival was also recorded.
KW  - chemotherapy
KW  - contemporary
KW  - metastatic prostate cancer
KW  - survival
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/64409
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-644094
SN  - 1097-0045
N1  - Benedikt Hoeh was awarded a scholarship by the Giersch Stiftung.
VL  - 81
IS  - 16
SP  - 1374
EP  - 1381
PB  - Wiley-Liss
CY  - New York, NY
ER  -