Clinical significance of pulmonary metastases in stage D2 prostate cancer patients

Abstract

Several prognostic factors such as the extent of bone metastases (EOD) in advanced prostate cancer (PCa) have been reported. Metastasis of the lung is rarely a significant clinical factor in the management of prostate cancer. The present study evaluates the clinical significance of lung metastases. We retrospectively reviewed the PCa database to identify patients with pulmonary metastases at initial diagnosis. The medical records of the patients were examined with respect to age, histologic grade, EOD score, marker response to endocrine therapy and clinical outcome. We then compared several potential clinical factors between patients with and without pulmonary metastases. Next, we retrospectively reviewed autopsy records of 60 Japanese patients who died of hormone-refractory metastatic PCa with particular focus upon metastatic profiles. A comparative study of stage D 2 patients with (n ¼ 20) and without (n ¼ 77) pulmonary metastases found no significant differences in EOD score, performance status, marker response and survival. Only tumor grade was better in the group with, than without pulmonary metastases (P ¼ 0.0120, chi-square analysis). In the series of autopsies, we found pulmonary metastases in 38 cases (63%), following metastases of the bone (57 cases, 95%) and lymph nodes (52 cases, 87%). A retrospective analysis of survival showed that patients with bone or lymph node metastases had a positive relative risk. In contrast, lung metastasis could be a positive prognostic indicator, although the findings were not statistically significant. These data suggest that the presence of pulmonary metastasis has no ominous impact on clinical course and disease outcome even in patients with disseminated prostate cancer.

Routine interval computed tomography to detect new soft‐tissue disease might be unnecessary in patients with androgen‐independent prostate cancer and metastasis only to bone

“…The significant difference in the percentages of patients with visceral metastasis only and those with bone metastasis suggests that these conditions have distinct biology. This is further supported by the observation that bone metastasis is an important prognostic factor in prostate cancer [10,20–22], while pulmonary metastasis has no significant effect on disease outcome [23].…”

Calcitonin Increases Tumorigenicity of Prostate Cancer Cells: Evidence for the Role of Protein Kinase A and Urokinase-Type Plasminogen Receptor

“…These distal lesions are often refractory to conventional therapies and continue to grow, resulting in high mortality associated with metastatic PC (56)(57)(58). Present results have shown that endogenous expression of hCT may be an important factor in oncogenicity of PC cells, and have identified that PKA is an important mediator of oncogenic actions of hCT in PC-3M and LNCaP cells.…”

Calcitonin increases invasiveness of prostate cancer cells: Role for cyclic AMP-dependent protein kinase A in calcitonin action

“…[58][59][60][61] These distal lesions are often refractory to conventional therapies and continue to grow, resulting in high mortality associated with metastatic prostate cancer. [62][63][64] Previous studies from our laboratory have shown that the expression of CT and its receptor is upregulated with the progression of prostate carcinoma. 9 The present results that CT causes a marked increase in their invasiveness by activating PKA-mediated intracellular mechanisms suggest the role for CT and PKA in increased tumorigenicity and invasiveness of advanced prostate tumors.…”