Men with Prostate Cancer Who Develop Disease-Related Complications Prior to Death

Chicago—There are few available data on disease-related complications such a bone fractures and urinary obstruction near the end of life in men who die of prostate cancer. Divya Yerramilli, MD, and colleagues conducted an analysis designed to examine the burden of disease-related complications in that patient population. Results of the analysis were reported during a poster session at the ASCO 2018 Annual Meeting in a poster titled Cancer-Related Morbidity at the End of Life in Men with Prostate Cancer.

The analysis utilized data from the Cancer Research-UK funded clustered randomized trial of prostate-specific antigen testing for prostate cancer on 2603 men who died within 10 years of prostate cancer diagnosis. Univariate analysis was used to examine the association between diagnostic risk-group, as defined by the National Comprehensive Cancer Network as low/intermediate, high, and metastatic. Kaplan-Meier analyses were used to compare median times to each disease-related complication. The study also included an assessment of a subgroup of men with metastatic disease who became castration-resistant.

Among men with higher risk disease at the time of study enrollment, there was a higher frequency of disease-related complications as well as shorter time to each disease-related complication. Of the 606 men at high risk, 19% developed cord compression, 16% had pathologic fracture, and 10% had renal failure. Men in the high-risk group had bone metastases at 2.9 months from diagnoses compared with 4.2 months among men in the low/intermediate risk group (P<.001). The odds of developing bone  metastases were higher in men with castration resistance  (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.53-2.55; P<.001) and urinary obstruction (OR, 2.10; 95% CI, 1.47-3.02; P<.001).

In conclusion, the researchers said, “In the largest contemporary cohort of prostate cancer patients, we found that a significant proportion of men experience cancer-related morbidity prior to death. Men with localized disease at diagnosis can have long intervals until development of disease-related complications. Furthermore, men who become castrate resistant are particularly vulnerable to disease-related complications.”

Source: Yerramilli D, Walsh E, Turner E, et al. Cancer-related morbidity at the end of life in men with prostate cancer. Abstract of a poster presented at the American Society of Clinical Oncology 2018 Annual Meeting, June 2, 2018, Chicago, Illinois.