Impact of Age at Diagnosis on Outcomes in Men with Castrate-Resistant Prostate Cancer (CRPC)
Bibliographic record
Abstract
BACKGROUND: The association between age and outcomes in men with castrate resistant prostate cancer (CRPC) is not well understood. OBJECTIVE: We aimed to evaluate CRPC patients to determine if their age at initial diagnosis impacted their cancer specific outcomes. DESIGN, SETTING, AND PARTICIPANTS: A retrospective chart review was conducted on 333 consecutive CRPC patients treated at the Princess Margaret Hospital (PMH) between 1995 and 2005. Patients were divided into 4 age categories, (A) <55, (B) 55-64, (C) 65-74 (reference), and (D) ≥ 75 years (yrs). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Primary endpoints included impact of age at diagnosis on overall survival (OS) and on prostate cancer specific survival. Secondary endpoints were time from diagnosis to development of CRPC, time from CRPC to death, and time from diagnosis to bone metastases. RESULTS AND LIMITATIONS: The median OS from diagnosis to death was: Group A 5.5 yrs (95% CI 3.0-7.5); Group B 6.7 yrs (95% CI 5.9-8.4); Group C 7.8 yrs (95% CI 6.6-9.3); and Group D 4.3 years (95% CI 2.9-5.0). The hazard ratio (HR) for death in Group D was 2.58 (95% CI 1.58-4.21, p=0.0002); and in Group A was 1.49 (95% CI 0.90-2.46, p=0.13). The duration of hormone sensitivity in Group D was less and predictive of OS, as was Gleason Score ≥8 and Stage 4 disease at diagnosis. CONCLUSIONS: Age at initial diagnosis appears to impact on outcome of patients who subsequently develop CRPC with a bimodal distribution of risk, with the shortest survivals in the ≥75 and <55 groups.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".