Castrate-Resistant Prostate Cancer with Peritoneal Metastases Treated with Docetaxel-Based Chemotherapy

Abstract

Introduction: To identify the risk factors, characteristics and prognosis of patients treated with docetaxel-based chemotherapy for peritoneal carcinomatosis due to metastatic castrate-resistant prostate cancer (mCRPC). Methods: We retrospectively reviewed our series of mCRPC patients with peritoneal metastases treated with docetaxel-based chemotherapy between 2004 and 2010. Results: Six patients were identified from our institutions' internal cancer registry. Three out of these patients had been treated with laparoscopic radical prostatectomy (LRP). In addition to peritoneal metastases, other metastatic sites were mainly visceral. Only 1 patient developed bone metastases. Peritoneal carcinomatosis occurred mainly in patients with a high Gleason (= or >6) score since 5 out of our 6 patients had a Gleason score ≥7. All 6 patients were treated with docetaxel-based chemotherapy when they developed castration resistance. Five patients benefitted from chemotherapy according to their PSA or RECIST responses. Median survival from the start of docetaxel was 24.5 months. Conclusions: Our retrospective analysis suggests that peritoneal carcinomatosis occurs mainly in patients with a high Gleason score. It is also possible that tumor seeding occurs during LRP. Patients with peritoneal carcinomatosis resistant to castration seem to benefit from docetaxel-based chemotherapy.

What are the odds? Prostate metastases to ureter and peritoneum

“…Also, there has been only one case of peritoneal metastasis with a Gleason score <7 8. A higher Gleason score might be associated with higher risk of ureteral and peritoneal metastases 25…”

“…This suggests that peritoneal metastases occur mainly in patients with a high Gleason score. Docetaxel-based chemotherapy seems to be a good therapeutic strategy in patients with malignant ascites and/or peritoneal metastasis 8. Survival after diagnosis of malignant ascites ranged from 1 to 43 months (but this was not always adequately reported).…”