1. In a retrospective analysis of 59,875 patients with metastatic prostate cancer, varying prognoses were found primarily depending on the site of metastasis

2. Asian patients had the best overall prognosis followed by African American and finally Caucasian patients

Evidence Rating Level: 3 (Average)

Prostate cancer is the fourth most diagnosed cancer in men and eight leading cause of cancer death worldwide. Localized prostate cancer has good survival outcomes, however, metastatic prostate cancer (mPC) confers a high risk of death. However, the effect on prognosis of the metastatic site has not yet been adequately studied. This retrospective analysis of the TriNetX database investigated the influence of different visceral metastatic sites on the prognosis of patients with prostate cancer. A total of 59,875 patients with metastatic prostate cancer were identified with 39,495 (65.2%) having bone metastases, 7,573 (12.5%) with lung only visceral metastases, 5,240 (8.7%) with brain only visceral metastases, and 7,567 (12.5%) with liver only visceral metastases. The median overall survival (OS) was 15.7 months. The longest median OS was for bone metastases at 44.4 months followed by lung metastases at 31.9 months. Brain and liver metastases had drastically lower median OS at 9.6 months and 10 months respectively. No statistical difference in OS were seen between brain and liver metastases but both experienced poorer prognosis relative to lung metastases. When patients had two visceral metastatic sites, the median OS was 8 months for liver and lung metastases. Liver and lung metastases had a median OS of 6.6 months. Liver and brain metastases had the lowest median OS at 3.1 months. Liver and brain metastases patients had a significantly lower median OS compared to liver and lung metastases (p<0.0001). Brain and lung metastases patients had a significantly higher median OS compared to liver and lung metastases patients (p<0.0001). In mPC patients with concomitant visceral and bone metastases, the median OS was 17 months with the worst prognosis being liver and bonee metastases (5.4 months, p<0.0001). In mPC with visceral metastases and concomitant lymph node metastases, the median OS was 42.2 months with the worst prognosis occurring in patients with no significant difference between brain + lymph node and liver + lymph node metastases. Patients with mPC with visceral metastases and concomitant bone and lymp node metastases, median OS were lower at 15 months. Patients with liver, bone, and lymph node metastases experienced thee worst survival outcome at 5.6 months (p = 0.004). When accounting for the race of patients, Asian patients had the highest survival followed by African American, and finally Caucasian patients.

Click to read the study in PLOSONE

Image: PD

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