UNASSIGNED: 211 Background: In the last 30 years, a major shift in initial staging has occurred for @entity1 with @entity263 (CaP) in many Western countries, with the incidence of detectable @entity3 at diagnosis decreasing from more than half the cases in the 1970s to currently less than 10%. Still, @entity263 is the second killing @entity5 in @entity1 . We used two prospective databases of @entity1 with @entity263 ( @entity263 ) to describe the natural history of metastatic @entity263 in the modern era. METHODS: The outcome of 190 @entity1 with CaP treated for @entity3 from 2007-2011 was studied. Characteristics of @entity1 who died from CaP were analyzed. RESULTS: After a median follow-up of 6.8 years, 112 @entity1 had died from CaP and 109 were assessable for presence of @entity3 at initial diagnosis. Of these 109 pts, 53 (49%) had detectable @entity3 at diagnosis: 43 pts (81%), 6 pts (11%) and 17 pts (32%) had bone, visceral; and lymph nodes @entity3 , respectively. Overall, 10 pts (19%) had more than one metastatic site. Median time to @entity263 was 16 months (range: 3-122 months) and median overall survival was 5 years (CI 95%: 4.6 - 6.6 years) for these pts with detectable @entity3 at diagnosis. Among @entity1 with localized CaP at diagnosis (n=56; 51%), 23 pts (41%) had T stage >=  3, 23 pts (41%) had a Gleason score >=  8. Their median PSA was 15 ng/ml (4-400). Overall, 39 pts (70%) were classified as having a high-risk CaP. 13 @entity1 (23%) dying from CaP had an initial Gleason score <=  6. The median overall survival was 7 years (CI 95%: 6.1 - 9.1 years). CONCLUSIONS: In the modern era, approximately half of the @entity1 eventually dying from CaP had detectable @entity3 at diagnosis. The paradigm of @entity1 progressing from localized disease to @entity3 and @entity204 is represented only in the other half. Further efforts should be made to conduct clinical trials in @entity1 with newly diagnosed @entity263 .

Who dies from XXXX in a Western country? A multicenter analysis.

@entity1 :: ('9606', 'Species') :: ['patients', 'men'] @entity263 :: ('MESH:D011471', 'Disease') :: ['castration-resistant prostate cancer', 'CRPC', 'metastatic prostate cancer', 'prostate cancer'] @entity5 :: ('MESH:D009369', 'Disease') :: ['neoplasm'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis', 'metastases', 'metastatic disease'] @entity204 :: ('MESH:D003643', 'Disease') :: ['eventually death']
@entity263 :: (MESH:D011471,Disease) :: ['prostate cancer']
