Metastasis-free survival is a strong surrogate for overall survival for localized prostate cancer, according to a meta-analysis of 28 trials involving nearly 29,000 individuals. It is linked with a significant risk of death from prostate cancer. Investigators looked at disease-free survival (n=21,140) and metastasis-free survival (n=12,712) in trials conducted between 1987 and 2011. Among the results:

• After a median follow-up of 10 years, 45% of men experienced disease-free survival.
• 45% experienced metastasis-free survival.
• 6 in every 10 patients who experienced disease-free survival were from radiation trials; 63% had high-risk disease.
• 9 in every 10 patients who experienced metastasis-free survival were from radiation trials; two-thirds had high-risk disease.
• At the patient level, Kendall’s τ correlation with overall survival was 0.85 for disease-free survival and 0.91 for metastasis-free survival.
• Treatment effects for the surrogates and overall survival were well correlated.