| Sumario: | Background and objectiveApproximately one third of men with metastatic prostate cancer die from causes other than prostate cancer. Little is known about the long-term outcomes of men with metastatic prostate cancer, in particular those who do not develop androgen pathway resistance. The objective of this study is to describe those with long term survival and disease response to initial therapy and their clinical outcomes.MethodsThis is a single institution, retrospective study of patients with metastatic hormone sensitive prostate cancer diagnosed prior to 1/1/2019 and alive as of 12/31/2024. Clinical and demographic features are described at baseline and follow up, with outcomes after treatment cessation.Key Findings and limitations145 patients were included with a median age at diagnosis of 61 years. 51 patients (35.2%) had metastatic disease at diagnosis and 108 (74.5%) had bone metastases at the time of metastatic disease. The median follow-up from the date of metastatic disease was 8.4 years. 89 (61.4%) patients continued to have disease response to initial therapy after a median of 8.8 years. 32 patients stopped therapy, and of those, 25 recovered testosterone, with 11 patients continuing to have an undetectable prostate specific antigen (PSA) (8% of total cohort and 34% of those who stopped therapy).Conclusions and clinical implicationsIn this cohort, most patients did not have further progression of disease, and 8% of patients had durable treatment-free remissions. Further research is needed on treatment cessation in men with exceptional responses to ADT.
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