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Stage IV Prostate Cancer: The Effect Of TNM Staging And Age Of Diagnosis On Survival

May 06, 2017

ORLANDO, FL (UroToday) - Are all Stage IV prostate cancer (CaP) patients the same? Individuals with distant metastases, regional lymphatic spread, and local invasion can all fall into this category.

Hsiao and colleagues examined the Stage IV CaP patients in the SEER database. 2,292 T4N0M0, 6,370 TxN1M0, and 20,633 TxNxM1 CaP patients were identified. Patients in these 3 TNM groups behaved differently. For instance, those with locally invasive (cT4 or pT4) disease, as expected, had a better prognosis than patients with TxN1M0 and TxNxM1 disease. Also, age at diagnosis did not predict survival in patients with metastatic disease, while younger patients with T4N0M0 and TxN1M0 disease did better than older patients even when controlling for co-morbidities. Interestingly, the authors also found that treatment with surgery (with or without XRT) for patients with locally invasive disease was associated with better outcomes.

This is likely a result of bias, since patients with T4N0M0 disease also significantly differ among themselves. It is likely that the patients with more favorable prognosis (e.g. focal bladder neck invasion) were more likely to undergo surgery than their higher risk counterparts.

Presented by Wayland Hsiao, MD, Guohui Zhou, MD, Michael Goodman, MD, Viraj A Master, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday Contributing Editor Alexander Kutikov, MD

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