Influence of the location and number of metastases in the survival of metastatic prostatic cancer patients

Guijarro, A.; Hernández, Virginia; Morena, J.M. De La; Jiménez-Valladolid, I.; Pérez‐Fernández, Elia; Peña, Enrique de la; Llorente, C.

doi:10.1016/j.acuroe.2017.03.001

Cited by 7 publications

(9 citation statements)

References 20 publications

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“…The OS and CSS varied based on the involvement sites of visceral metastases and the number of visceral metastasis involved. Guijarro et al ( 16 ) found that patients with visceral involvement has a worse prognosis compared with exclusively LN metastasis, exclusively bone metastasis, or LN plus bone metastasis, which was in accordance with Mazzone’s ( 17 ) research. In addition, Mazzone et al ( 17 ) also suggested that the prognosis of patients with bone involvement alone was inferior to those with LN involvement alone.…”

Section: Discussionsupporting

confidence: 75%

Risk factors of developing visceral metastases at diagnosis in prostate cancer patients

Xu¹,

Wu²,

Ke³

et al. 2019

Transl. Cancer Res

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Background Risk factors of visceral metastases in prostate cancer (PCa) patients are unclear. The aim of this study is to investigate the risk factors of developing visceral metastases at diagnosis and the impact of these risk factors on the survival of patients with visceral metastatic PCa. Methods Patients with visceral metastases at the time of diagnosis of [2010–2015] PCa were identified using the Surveillance, Epidemiology, and End Results (SEER) database. Visceral metastatic distribution data were provided for liver, lung, and brain. The overall survival (OS) was calculated by the Kaplan-Meier method. Multivariable logistic and Cox regression models were performed to identify risk factors and analyze survival outcomes. Results A total of 13,092 eligible patients with stage IV PCa were identified from SEER database. A total of 598 patients developed visceral metastases at diagnosis among these patients. In multivariable analyses, patients with PSA >80 ng/mL had 1.545-fold higher risk of developing visceral metastases compared with those with PSA <20 ng/mL (P<0.001). The presence of bone metastasis and lymph node (LN) metastases were represented as risk factors of visceral metastases in stage IV PCa patients. Patients with two or three metastatic sites had 1.604-fold higher risk of shorter OS compared with those with one metastatic site (P<0.05). And patients with bone plus visceral metastases had 1.410-fold higher risk of shorter OS compared with those with visceral metastasis only (P<0.05). Age ≥70 had 1.621-fold higher risk of shorter OS compared with those with age <70 (P<0.05). T4 stage had 1.476-fold higher risk of shorter OS compared with those with T1 stage (P<0.05). Conclusions The incidence rate was increased among patients with visceral metastases in stage IV PCa at diagnosis. PSA over 80 ng/mL, the presence of bone metastasis and the presence of LN metastases were risk factors associated with a higher rate of development of visceral metastases in stage IV PCa patients. The presence of visceral plus bone metastases, two or three sites, age over 70, and T4 stage represent prognostic factors on survival outcomes in visceral metastatic PCa patients.

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Section: Discussionsupporting

confidence: 75%

Risk factors of developing visceral metastases at diagnosis in prostate cancer patients

Xu¹,

Wu²,

Ke³

et al. 2019

Transl. Cancer Res

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“…The distribution of metastatic involvement has been shown to carry prognostic value in several malignancies. [10][11][12][13][14][15][16][17] The tendency of a tumor to metastasize to a particular organ site may reflect an interplay between the underlying biology of the tumor cells and a permissive host organ microenvironment. [18][19][20][21] In the setting of a TGCT, the involvement of extranodal nonpulmonary sites is traditionally associated with poor outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…The distribution of metastatic involvement has been shown to carry prognostic value in several malignancies . The tendency of a tumor to metastasize to a particular organ site may reflect an interplay between the underlying biology of the tumor cells and a permissive host organ microenvironment .…”

Section: Discussionmentioning

confidence: 99%

Site of extranodal metastasis impacts survival in patients with testicular germ cell tumors

Patel

Singla

Ghandour

et al. 2019

Cancer

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Background Using a large, nationally representative, population‐based cancer registry, this study systematically evaluated the impact of the location and burden of extranodal testicular germ cell tumor (TGCT) metastases on survival. Methods Men with stage III TGCTs captured by the Surveillance, Epidemiology, and End Results registry from 2010 to 2015 with distant extranodal metastases were identified. Clinicopathologic information was collected, and patients were subdivided according to the specific organ site or sites of metastatic involvement (lung, liver, bone, and/or brain). Kaplan‐Meier analysis and multivariable Cox regression were used to evaluate cancer‐specific survival (CSS), and model performance was assessed with Harrell's C statistic. Results Nine hundred sixty‐nine patients with stage III TGCTs were included with predominantly nonseminomatous histology (84%). Most patients (91%) had pulmonary metastases, whereas 20%, 10%, and 10% had liver, bone, and brain metastases, respectively. Over a median follow‐up of 21 months, 19% of these men died of TGCTs. When they were grouped by the primary site of metastasis, patients with more than 1 extrapulmonary metastasis exhibited the worst CSS (hazard ratio [HR] vs isolated pulmonary involvement, 4.27; 95% confidence interval [CI], 2.60‐7.00; P < .01). Among patients with isolated extrapulmonary involvement, those with brain metastases had the poorest survival (HR, 3.24; 95% CI, 1.98‐5.28; P < .01), and they were followed by patients with liver (HR, 2.29; 95% CI, 1.56‐3.35; P < .01) and bone metastases (HR, 1.97; 95% CI, 1.11‐3.50; P = .02). Harrell's C statistic (multivariable) was 0.71. Conclusions The site of metastatic involvement affects survival outcomes for patients with TGCTs, and this may reflect both the aggressive biology and the challenging treatment of these tumors. Further incorporation of organotropism into current prognostic models for metastatic TGCTs warrants attention.

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“…Multiple metastases, particularly in the presence of visceral or brain metastases, significantly limit survival and the indication for surgical treatment should be determined cautiously [13]. With regard to the tumour entity, the median probability of survival of ▶ patients with bone metastases of breast cancer, prostate cancer and thyroid cancer is in the region of years, whereas other entities, particularly bronchial cancer and malignant melanoma, limit survival to months [1,14].…”

Section: Assessment Of the Patient-specific Prognosismentioning

confidence: 99%

“…Besides the primary tumour entity, consideration should be given to the site of the metastasis. In the case of prostate cancer, involvement of only the axial skeleton is associated with a higher life expectancy than involvement of the bones in the extremities [13]. Moreover, the general condition of the patient (Karnofsky index, ASA score) is relevant to the prognosis.…”

Section: Assessment Of the Patient-specific Prognosismentioning

confidence: 99%

Bone Metastases – Pathophysiology, Diagnostic Testing and Therapy (Part 2)

et al. 2019

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The second part of this review deals with the several options for the surgical therapy of bone metastases according to their anatomical site and the patientʼs individual prognosis. Although metastases to the bone – with few exceptions – are normally given palliative therapy, patients nowadays reach survival times of several months to years, depending on the underlying tumour entity. Scoring systems are suitable to estimate the patientʼs prognosis and fracture risk. The indication for operation has to be adapted to these parameters. In order to preserve a high quality of life, a limb saving procedure has to be aimed at. The options include the resection of the metastasis with stabilisation, the sole stabilisation of the affected bone, and wide resection with limb reconstruction using a modular tumor endoprosthesis. With todayʼs anaesthesiological peri- and intraoperative care, a vast number of surgical implants and bone augmentations are available. However, what is important is not the practicability of the procedure, but the oncological justification and patient-adapted selection of surgical therapy.

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Influence of the location and number of metastases in the survival of metastatic prostatic cancer patients

Cited by 7 publications

References 20 publications

Risk factors of developing visceral metastases at diagnosis in prostate cancer patients

Risk factors of developing visceral metastases at diagnosis in prostate cancer patients

Site of extranodal metastasis impacts survival in patients with testicular germ cell tumors

Bone Metastases – Pathophysiology, Diagnostic Testing and Therapy (Part 2)

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