Department of Urology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California.
Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
Urol Pract. 2024 May;11(3):489-497. doi: 10.1097/UPJ.0000000000000557. Epub 2024 Apr 19.
Therapeutic options for men with metastatic prostate cancer have increased in the past decade. We studied recent treatment patterns for men with metastatic prostate cancer and how treatment patterns have changed over time.
Using the Surveillance, Epidemiology, and End Results‒Medicare database, we identified fee-for-service Medicare beneficiaries who either were diagnosed with metastatic prostate cancer or developed metastases following diagnosis, as indicated by the presence of claims with diagnoses codes for metastatic disease, between 2007 and 2017. We evaluated treatment patterns using claims.
We identified 29,800 men with metastatic disease, of whom 4721 (18.8%) had metastatic disease at their initial diagnosis. The mean age was 77 years, and 77.9% of patients were non-Hispanic White. The proportion receiving antineoplastic agents within 3 years of the index date increased over time (from 9.7% in 2007 to 25.9% in 2017; .001). Opioid use within 3 years of prostate cancer diagnosis was stable during 2007 to 2013 (around 73%) but decreased through 2017 to 65.5% ( .001). Patients diagnosed during 2015 to 2017 had longer median survival (32.6 months) compared to those diagnosed during 2007 to 2010 (26.6 months; .001).
Most metastatic prostate cancer patients do not receive life-prolonging antineoplastic therapies. Improved adoption of effective cancer therapies when appropriate may increase length and quality of survival among metastatic prostate cancer patients.
在过去的十年中，转移性前列腺癌患者的治疗选择有所增加。我们研究了转移性前列腺癌患者的近期治疗模式以及治疗模式随时间的变化。
使用监测、流行病学和最终结果-医疗保险数据库，我们确定了 2007 年至 2017 年间，在有转移性疾病诊断代码的索赔存在的情况下，被诊断为转移性前列腺癌或在诊断后出现转移的服务收费医疗保险受益人。我们使用索赔评估治疗模式。
我们确定了 29800 名患有转移性疾病的男性，其中 4721 名（18.8%）在初始诊断时就患有转移性疾病。平均年龄为 77 岁，77.9%的患者是非西班牙裔白人。在索引日期后的 3 年内接受抗肿瘤药物治疗的比例随着时间的推移而增加（从 2007 年的 9.7%增加到 2017 年的 25.9%；<.001）。在前列腺癌诊断后的 3 年内，阿片类药物的使用在 2007 年至 2013 年期间保持稳定（约 73%），但到 2017 年降至 65.5%（<.001）。与 2007 年至 2010 年相比，在 2015 年至 2017 年期间诊断的患者的中位生存期（32.6 个月）更长（26.6 个月；<.001）。
大多数转移性前列腺癌患者没有接受延长寿命的抗肿瘤治疗。在适当的情况下，更有效地采用有效的癌症治疗方法可能会增加转移性前列腺癌患者的生存时间和生活质量。
