Skeletal complications and survival of HRPC patients

It is well understood that skeletal complications are a crucial factor in the quality of life and the prognosis of patients with hormone-refractory prostate cancer (HRPC); however, their true prevalence and impact on the prognosis remain largely unknown.

Inoue et al. have analyzed the prevalence of skeletal complications and survival of HRPC patients in retrospective series of 151 patients treated at a single Japanese institution between 1990 and 2004. The medical records of the patients were reviewed for documentation of skeletal complications, and overall survival was calculated from the date of diagnosis of HRPC.

The results of this study show that:

  • At the time of diagnosis of HRPC, bone metastases and bone pain were observed in 83.8 and 44.7 percent of patients, respectively.
  • During their follow-up management
    • 80.0 and 14.2 percent of patients experienced bone pain and bone fracture, respectively.
    • 74.2  percent of patients received non-steroidal anti-inflammatory drugs and 43.9 percent of patients received opioids for bone pain.
    • 50.9 percent of the patients underwent radiotherapy for palliative pain control.
  • A high score on the extent of disease observed on the bone scan and the presence of bone pain at time of diagnosis of HRPC were independent prognostic factors for overall survuival.

The authors conclude that, historically, there has been a high prevalence of skeletal complications and a high mortality rate in Japanese HRPC patients. Patients with bone pain at the time of diagnosis of HRPC have had a significantly poorer prognosis than those without.

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