Objectives
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. In this study, we retrospectively
investigated the prevalence of skeletal complications and survival of HRPC patients
in a single Japanese institute.
Methods
From 1990 to 2004, 151 patients with prostate cancer were estimated to have HRPC after
androgen ablation therapy in a single institute. The medical records of the patients
were reviewed for documentation of skeletal complications, and overall survival was
calculated from the diagnosis of HRPC.
Results
At the diagnosis of HRPC, bone metastases and bone pain were observed in 83.8% and
44.7% of patients, respectively. During follow-up, 80.0% and 14.2% of patients experienced
bone pain and bone fracture, respectively. Moreover, 74.2% and 43.9% of the patients
received nonsteroidal anti-inflammatory drugs and opioids for bone pain, respectively,
and 50.9% 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 the diagnosis of HRPC were independent prognostic factors on multivariate
analysis (hazard ratio = 1.753 and 2.118, P = .033 and .007, respectively).
Conclusions
Despite a small number of subjects, our retrospective survey demonstrated the high
prevalence and mortality rate of skeletal complications in Japanese HRPC patients.
Patients with bone pain at the diagnosis of HRPC had significantly poorer prognosis
than those without.
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Article info
Publication history
Accepted:
July 31,
2008
Received:
May 10,
2008
Identification
Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
