LIFE EXPECTANCY (SURVIVAL DATA) STAGE 4 PROSTATE
CANCER
The life expectancy of a patient with stage 4
prostate cancer is, of course, an estimate based
on studying the clinical course of many patients.
Each patient is unique. There are many different factors
which affect the overall survival data even among patients with
the same stage of disease.
About 1 in 3 (30%) patients with advanced prostate
cancer will live for more than five years after diagnosis. On
average, patients with metastatic prostate cancer may
see some response to treatment for about 12 to 18 months.
Average survival after that is about another two years.
Researchers are continuing to refine prognostic models for
patients with metastatic prostate cancer.
In one study, 10 independent prognostic factors other
than treatment group were identified in multivariate analysis.
These factors were:
(a) presence of liver metastases [hazard ratio (HR),
1.66; P = 0.019];
(b) number of metastatic sites (HR, 1.63 if > or =2
sites; P = 0.001);
(c) clinically significant pain (HR, 1.48; P <
0.0001);
(d) Karnofsky performance status (HR, 1.39 if < or
=70; P = 0.016);
(e) type of progression (HR, 1.37 for measurable
disease progression and 1.29 for bone scan progression; P =
0.005 and 0.01, respectively);
(f) pretreatment prostate-specific antigen (PSA)
doubling time (HR, 1.19 if <55 days; P = 0.066);
(g) PSA (HR, 1.17 per log rise; P < 0.0001);
(h) tumor grade (HR, 1.18 for high grade; P =
0.069);
(i) alkaline phosphatase (HR, 1.27 per log rise; P
< 0.0001);
(j) hemoglobin (HR, 1.11 per unit decline; P =
0.004).
A nomogram was developed based on this multivariate model
and validated internally.
Further testing with other patient populations may support
the further use of this normogram.
It is important to
remember that statistics always lag to a certain
degree the current reality. By the time results are published,
treatments may have advanced and the statistics may have
improved somewhat.
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