Changes in conditional net survival and dynamic prognostic factors in patients with newly diagnosed metastatic prostate cancer initially treated with androgen deprivation therapy

Abstract

Background The purpose of this study was to identify predictive factors associated with conditional net survival in patients with metastatic hormone‐naive prostate cancer (mHNPC) initially treated with androgen deprivation therapy (ADT). Methods At nine hospitals in Tohoku, Japan, the medical records of 605 consecutive patients with mHNPC who initially received ADT were retrospectively reviewed. The Pohar Perme estimator was used to calculate conditional net cancer‐specific survival (CSS) and overall survival (OS) for up to 5 years subsequent to the diagnosis. Using multiple imputation, proportional hazard ratios for conditional CSS and OS were calculated with adjusted Cox regression models. Results During a median follow up of 2.95 years, 208 patients died, of which 169 died due to progressive prostate cancer. At baseline, the 5‐year CSS and OS rates were 65.5% and 58.2%, respectively. Conditional 5‐year net CSS and OS survival gradually increased for all the patients. In patients given a 5‐year survivorship, the conditional 5‐year net CSS and OS rates improved to 0.906 and 0.811, respectively. Only the extent of disease score (EOD) ≥2 remained a prognostic factor for CSS and OS up to 5 years; as survival time increased, other variables were no longer independent prognostic factors. Conclusions The conditional 5‐year net CSS and OS in patients with mHNPC gradually increased; thus, the risk of mortality decreased with increasing survival. The patient's risk profile changed over time. EOD remained an independent prognostic factor for CSS and OS after 5‐year follow‐up. Conditional net survival can play a role in clinical decision‐making, providing intriguing information for cancer survivors.

Dynamics of conditional survival and risk factors in androgen deprivation therapy for prostate cancer using a multi‐institutional Japan‐wide database

“…14 Furthermore, Narita et al showed improved conditional CSS and OS in patients with metastatic prostate cancer in Japan. 16 In a similar manner, the present study showed that conditional OS in stage IV and high-risk patients as per the J-CAPRA system have improved over time. In patients with advanced and high-risk disease, high mortality from prostate cancer in patients with poor prognosis might explain the reason for consistent improvement in conditional CSS and OS.…”

“…In addition, Narita et al reported unchanged prognostic impact of disease extent on bone in metastatic prostate cancer, the parameter that was not unavailable in the present study. 16 The findings in the present study showed several clinical implications. There was gradual improvement in the survival over time; therefore, de-escalation of treatment in patients with reduced risk might be considered.…”

“…[11][12][13][14] In prostate cancer, conditional survival and the change in prognostic factors have been reported. [14][15][16][17] Studies using nationwide databases, including the SEER database and the Korean National Health Insurance Service database, have reported gradual improvements in conditional survival. 14,15 However, few studies have reported on conditional survival in ADT for prostate cancer.…”

Process Mining the Performance of a Real-Time Healthcare 4.0 Systems Using Conditional Survival Models

“…Despite getting increased popularity in healthcare [35][36][37][38][39][40], to our knowledge this is the first time the technique presented in this paper has been used for dynamic modelling of the performance of real-time Healthcare 4.0 alerting systems, as well as for the indirect evaluation of the quality of received care.…”

Narrative review of urinary glycan biomarkers in prostate cancer

“…Many studies suggested the role of glycans as potential biomarkers for diseases (38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54). A broad range of glycan alterations have been observed in blood-based or tissuebased analysis, including aberrant PSA glycosylation, increased sialylation, core fucosylation, O-GlcNAcylation, and branched N-glycan formation (55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71).…”