Prognostic factors in disseminated prostatic cancer, with special emphasis on extent of disease

Current clinical trials in disseminated prostatic cancer mostly use M0 or M1 to identify two prognostically different groups of patients. Soloway et al. [Cancer 1988;61:195-202] have shown a significant difference in survival depending on the extent of disease (EOD) on bone scan in M1 disease. Seventy-three prostatic cancer patients with bone-scan-proven metastases (T0-4 Nx M1 G1-3) from the Aust-Agder County in Norway with observation time 2-9 years were followed. The impact of T stage, grade, serum acid phosphatase status and EOD on survival was analyzed. EOD was assessed according to Soloway et al. No statistically significant difference could be demonstrated according to T stage or histological grade. A statistically significant difference in survival could be demonstrated both for normal versus elevated serum acid phosphatase and for EOD. EOD I/II had a better prognosis than EOD III/IV. Stratification of patients in EOD categories seems relevant, but the relative importance of the different EOD categories is not yet established.