Abstract:

Objective: Bone metastases, which show a milder course compared with visceral disease, are among the most common metastatic sites in prostate cancer. In the present study, we aimed to investigate the prognostic factors that influence the survival time in the castration-sensitive phase in patients diagnosed with prostate adenocarcinoma with isolated bone metastasis. Materials and Methods: The prognostic effects of the clinical (performance status, number of bone metastases) and laboratory parameters of a total of 217 patients, of whom the data could be accessed, on survival in the castration-sensitive phase were evaluated. Results: Of the 217 patients included in our study, 144 (66.4%) were metastatic at presentation. The mean age of the patients was 68.4 (42-88) years. The mean follow-up duration was 44 months. Of our 217 patients, 125 (57.6%) were included in the castration-sensitive group and 92 (42.4%) in the castration-resistant group. In multivariate analyses; lactate dehydrogenase, alkaline phosphatase (ALP) levels and the number of bone metastases were independent prognostic factors with a strong correlation with time to castration-resistant prostate cancer. The evaluation of these three parameters within the framework of a prognostic index and subsequent risk stratification revealed median progression-free survival times of 91, 36, 20 and 12 months for the very low-risk, low-risk, intermediate-risk and high-risk groups, respectively. Conclusion: Lactate dehydrogenase, ALP levels and the number of bone metastases were determined as strong and useful prognostic factors in predicting time to castration-resistant prostate cancer in metastatic prostate cancer.

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