The following article features coverage from the American Urological Association (AUA) 2019 meeting. Click here to read more of Renal & Urology News’ conference coverage.

CHICAGO—Bone pain in men with metastatic castration-resistant prostate cancer (mCRPC) is the strongest predictor of skeletal-related events (SREs), according to study findings presented at the 2019 American Urological Association annual meeting.

In addition, the number of bone metastases at mCRPC diagnosis is the strongest predictor of death from any cause.

The findings are from a retrospective review of data from 837 men initially diagnosed with nonmetastatic CRPC who later developed bone metastases. The median age at mCRPC was 76 years. Of these, 362 (43%) reported bone pain and 44 (5%) had visceral metastases at the time of mCRPC.


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SREs occurred in 287 men (33%) and 740 (85%) died. The median follow-up was 26 months. Of the 287 men, 236 (82%) who experienced an SRE received bone radiation. Bone pain was significantly associated with a 3-fold increased risk of SREs, Ingrid Lorese Tablazon, of the Durham VA medical center in Durham, North Carolina, and collaborators reported in a poster presentation. The investigators defined SREs as pathologic fracture, radiation to the bone, spinal cord compression, and surgery to the bone.

Other factors significantly associated with increased SRE risk were shorter time from ADT to CRPC, shorter time from CRPC to metastasis, and presence of visceral metastases.

In addition, compared with patients who had 1 bone metastasis, those with 10 or more bone metastases had a significant 2-fold increased mortality risk. Patients with 2 bone metastases and 3 to 9 bone metastases had a significant 1.36- and 1.4-fold increased mortality risk, respectively.

“Among men with bone mCRPC, bone pain was the strongest predictor for SREs and number of bone metastases was a strong predictor for mortality,” the authors concluded.

Read more of Renal & Urology News’ coverage of the AUA 2019 meeting by visiting the conference page.

Reference

Tablazon IL, Howard L, De Hoedt A, et al. Predictors of skeletal related events and overall survival in men with metastatic, castration-resistant prostate cancer: Results from the SEARCH database. Presented at the 2019 American Urological Association annual meeting held May 3-6 in Chicago. Abstract MP34-10.