Gordon, Olivia

Luu, Jennica

Nagao, Paul

Whalen, Michael

English

George Washington University: Health Sciences Research Commons (HSRC)

Definitive Local Treatment for Metastatic Prostate Cancer: An NCDB Retrospective StudyPaul Nagao, M.A., 1 Jennica Luu, B.S.,1 Olivia Gordon, B.S.,1 Michael Whalen M.D.21George Washington University School of Medicine and Health Sciences, Washington, DC; 2George Washington University Medical Faculty Associates, Washington, DC• Current standard of therapy for metastatic prostate cancer (mPCa) is androgen deprivation therapy (ADT) combined with chemohormonal therapy• Another parallel approach is the use of definitive local treatment (LT) to the prostate via pelvic radiotherapy (RT) or radical prostatectomy (RP) • Study Aims: To compare the use of LT with ADT vs. ADT alone in the setting of metastatic prostate cancerBackground/AimsMethodsResults• Definitive local treatment in addition to ADT significantly improves 5-year OS for patients with metastatic prostate cancer. • There is a significant improvement in patient outcomes for those who are treated with RP vs RT. • These findings support multimodal treatment for metastatic prostate cancer, and further studies are needed to optimize the choice of definitive LT in this setting.ConclusionsPaul Nagaoprnagao@gwu.eduContactADT + Radiation Therapy (RT)n=2884Metastatic PCaN=36,635Androgen Deprivation Therapy (ADT) Alonen=33,438ADT + Local Treatment (LT)n=3197ADT + Radical Prostatectomy (RP)n=313• For ADT alone, 5-year OS was 31.3% (CI= 30.7-31.8%) vs. 54.2%. (CI= 52.4-56.1%) for LT+ADT. • Furthermore, comparing the type of LT on KM analysis: RP + ADT showed better 5-yr OS, 74.0% (CI= 67.5-79.1%) vs. 52.2% (CI= 50.2-54.2%) for XRT+ADT (p<0.001).Results (Cont.)• The National Cancer Database (NCDB) was queried from 2004-2017 to conduct a retrospective cohort analysis of cTanyNanyM1 PCa who received LT + ADT vs. ADT alone. • Patients with less than 6 months of follow-up, treatment history of orchiectomy or palliative care were excluded.• Clinicopathologic variables were compared using appropriate statistical tests of comparison for continuous or categorical variables.• Cox Proportional Hazards Model was used to identify predictors of Overall Survival (OS). The Kaplan-Meier (KM) method and log rank test were used to compare OS for LT+ADT vs. ADT alone. Outcome Overall Survival % (95% CI)ADT AloneADT + LTADT + RPADT + XRT5 years 31.3 (30.7 - 31.8)54.2 (52.4 - 56.1)74(67.5 - 79.1)52.2 (50.2 - 54.2)• Patients treated with ADT alone were more likely to be older and have a higher PSA score (P <0.001)• The proportion of LT increased over the study period from 3.3% in 2004 to 15.4% in 2017 • Median follow-up was 2.8 years

Definitive Local Treatment for Metastatic Prostate Cancer: An NCDB Retrospective Study

https://hsrc.himmelfarb.gwu.edu/cgi/viewcontent.cgi?article=1254&context=gw_research_showcase

Definitive Local Treatment for Metastatic Prostate Cancer: An NCDB Retrospective Study

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