Clinical Outcome of Taiwanese Men With Metastatic Prostate Cancer Compared With Other Ethnic Groups
Received 9 December 2007; accepted 16 January 2008. published online 27 March 2008.
Objectives
Prostate cancer incidence varies significantly among different ethnic groups. However, little is known about the survival outcome among groups. We sought to compare the survival outcome in patients with metastatic prostate cancer among different ethnic groups and to identify independent prognostic factors affecting overall survival in Taiwanese patients.
Methods
From January 1996 to February 2005, 482 men with newly diagnosed metastatic prostate adenocarcinoma were enrolled from five major medical centers in Taiwan. The cohort accounted for about 11.5% of all patients with metastatic disease during the period in Taiwan. The demographics, tumor characteristics, and survival outcome were compared with several published Western and Japanese series. Five series were selected from MEDLINE: the Southwest Oncology Group; Detroit Metropolitan Surveillance, Epidemiology, and End Results Program Registry; American College of Surgeons; National Cancer Registry in Sweden; and Gurma and Nagasaki University Group in Japan.
Results
The Taiwanese patients were the oldest among the selected series. The median overall survival of our patients was 38.4 months (95% confidence interval 33 to 45 months), which was longer than that in the Western series (median 25 to 32 months) and similar to those in the Japanese series (median 36 months). In a multivariate analysis with age adjustment, bone pain, Gleason score 8 or greater, and visceral metastases independently predicted a reduced overall survival in our series compared with each favorable strata (hazard ratio 2.22, 1.96, and 1.51, respectively; all P <0.05).
Conclusions
Taiwanese men with metastatic prostate cancer might have a better survival compared with Western men.
aDepartment of Urology, National Taiwan University Hospital, Taipei, Taiwan
bDivision of Urology, Taoyuan General Hospital, Department of Health, Taoyuan, Taiwan
cDepartment of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
dDepartment of Urology, Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
eDepartment of Urology, China Medical University Hospital, Taichung, Taiwan
fDivision of Urology, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
Reprint requests: Yeong-Shiau Pu, M.D., Ph.D., Department of Urology, National Taiwan University College of Medicine and Hospital, 7 Chung-Shan South Road, Taipei 10002 Taiwan
Yen-Hwa Chang, M.D., Ph.D., Division of Urology, Department of Surgery, Taipei Veterans General Hospital 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan 112
ABSTRACT