Prognostic factors in patients with advanced prostatic cancer

Lee, Kyu Seung; Paick, Jae Seung; Lee, Chongwook

Abstract

We analyzed the risk factors to the survival in 80 patients with advanced prostatic cancer who were managed in Seoul National University Hospital from 1979 to 1987. Variables were age, weight loss, hemoglobin, serum acid and alkaline phosphatase, pain, extent of metastasis on bone scan, Gleason`s sum metastatic site and treatment regimens. Univariate analysis using Logrank test and multivariate analysis of Cox`s proportional hazards regression model was performed. Median follow-up was 56 months (11-112) and median survival was 29 months in overall patients. The l, 3 and 5-year survival rate was 75%, 40%, and 17% respectively. In univariate analyses anemia, weight loss, Gleason`s sum, serum acid phosphatase, extent of metastasis on bone scan influenced the survival significantly(P<0.05). Multivariate analysis identified anemia and weight loss as the most important factor, followed by Gleason`s sum and the serum acid phosphatase level. serum acid phosphatase level. Based on these prognostic factors we divided the patients into 2 groups: the low and high risk group, with median survival of 44 and 15 months, 3 year survival rate of 64% and 4%, respectively. These prognostic factors and grouping may be useful for anticipating the fate of individual patient and the biologic behavior of the tumor. The effective management could be planned according to these criteria.