Changes in conditional net survival and dynamic prognostic factors in patients with newly diagnosed metastatic prostate cancer

[snoraste]

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

ncbi.nlm.nih.gov/pmc/articl...

"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."

I was looking for a study that looked at the "conditional" survival (given you have survived x-number of years, what is the probability of surviving another y-years). This one caught my attention. Intuitively, the results make sense. I was hoping to see some quantitative analysis, and this report seems to be providing something reasonable (subject to the limitations clause). Its database does not include the combined ADT+Abi/Chemo cohort, but the results should be indicative.

[6357axbz]

Interesting post. A bit tough to wade through though. I like this part:

“In conclusion, the conditional 5‐year net CSS and OS rates in patients with mHNPC gradually increased in the years following ADT treatment, implying that the risk of mortality decreased with increasing length of survival.”

I think this means the longer you live following ADT means a greater likelihood of living even longer and your risk of mortality is decreased.

Perhaps our more knowledgeable brothers here will chime in.

[snoraste in reply to 6357axbz]

Correct. The concept is: the longer you live, the longer your life expectancy. Sounds trivial, but it's not. It's similar to population life expectancy. For example, in 2017:

Male life expectancy in the US at BIRTH = 75.97

If the Male survives to age 60, life expectancy = 81.58

(ssa.gov/OACT/STATS/table4c6...

So the message in the article is that the longer you live from time of metastatic diagnostic (they went to max of 5years post diagnosis), the higher chances (in general) of making it in the following 5 years. So there's a correlation there.

[Hidden]

It seems I should be dead. My PSA last month was 0.05. I don't buy into these median survival studies. Some guys leave the earth after two years, others are still cutting the front lawn after ten years or so. Luck of the draw.

[snoraste in reply to Hidden]

Not familiar with your case, but I'm glad you're still alive. This study is not a prognosis. It's a statistical analysis. Same as the case with the general population age studies (see my post above), not everyone who makes it to 60 will have additional 21.58 years left. But "on average", people who make it to 60yr, live about 5.5years longer than baseline.

[LearnAll]

Wow ! Longer we live with PCa...longer we will live..!! Interesting. Lets keep pushing our PCa apple cart !

[MateoBeach in reply to LearnAll]

And our lawn mowers. No wait. I have a guy who does that. 💪💪😆😆😆😆

[LearnAll in reply to MateoBeach]

Absolutely !...move our lawn mowers ourselves...wife happy.. money saved and health improved.

Also, we should start growing our herb garden. Its so easy to grow Turmeric, Ginger, Onions, Garlic, Chilli peppers ,Okra and sweet potato. . I tried it this summer..it was a great experience. Thank God, I live in a tropical climate with lot of Sunshine...so Vitamin D is free too.

[Hidden]

A factor that wouldn't be included in this is new treatments coming along and living long enough to have access to those.

The longer you live, the more life extending treatments you have access to. Around 10 years ago, many of the treatments we are taking advantage were not available.

Living another year might give you access to a drug that could give you one more year.

[dhccpa in reply to Hidden]

The patients in the mix may have widely varying underlying health conditions. I've read that many, perhaps most, PCa patients die of something other than PCa.

[snoraste in reply to dhccpa]

This study is specifically on the mHSPC patients. If you read thru, they measure both Cancer Specific Survival, CSS and Overall Survival, OS. In larger studies (if I remember correctly LATTITUDE/STAMPEDE), there's 15-20% difference between CSS and OS, meaning 15-20% of patients died for causes other than PCa. Cardiovascular is at the top of that list.

[dhccpa in reply to snoraste]

What exactly happens to patients who die of prostate cancer? I've asked doctors but the question seems to make them too uncomfortable to answer.

[snoraste in reply to dhccpa]

That's a very different question from what's being discussed here. I suggest you search the site, or start a new topic.

[dhccpa in reply to snoraste]

Will do, didn't mean to veer off topic.

[V10fanatic in reply to dhccpa]

We all go straight to Heaven and are given the biggest motor muscle car of our choice upon entry. There are no speed traps in Heaven!!

[SPEEDYX in reply to V10fanatic]

Remember narrow is the way...I will take my 1990 porsche 928 supercharged....pretty narrow car...Lol

[Magnus1964]

Sounds reasonable. I have been on ADT for decades.

[snoraste in reply to Magnus1964]

and hopefully decades more.

[j-o-h-n]

** To view/listen to video just click on the title on top of the video **

youtube.com/watch?v=b9024VF...(Not working as expected?)

Good Luck, Good Healt and Good Humor.

j-o-h-n Tuesday 10/06/2020 6:10 PM DST