Prognostic impact of bone metastatic volume beyond vertebrae and pelvis in patients with metastatic hormone-sensitive prostate cancer

Suzuki, Kotaro; Okamura, Yasuyoshi; Hara, Takuji; Taguchi, Tomoaki; Furukawa, Junya; Harada, Kiyoshi; Hinata, Nobuyuki; Fujisawa, Masato

doi:10.1007/s10147-021-01931-x

Cited by 7 publications

(7 citation statements)

References 29 publications

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“…Interestingly, increased novel TV is associated with poor prognosis for mHSPC and prognostic biomarkers for mHSPC, including PSA, Hb, Alb, and BSI. 21,22 By contrast, in patients with mCRPC, novel TV was associated with ALP, LDH, and CRP, but not with other clinical factors including BSI. Bone scans can identify bone metastases accompanied by an osteoblastic reaction; however, they cannot identify rapid growth osteolytic metastases due to the absence of reactive changes.…”

Section: Discussionmentioning

confidence: 85%

Novel quantitative software for automatically excluding red bone marrow on whole‐body magnetic resonance imaging in patients with metastatic prostate cancer: A pilot study

et al. 2022

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Objectives To establish a novel quantitative method that automatically excludes the red bone marrow and accurately quantifies the tumor volume on whole‐body magnetic resonance imaging using updated imaging software. To also evaluate the association between the quantified tumor volume and the prognosis of patients with metastatic prostate cancer. Methods This prospective analysis included patients diagnosed with metastatic hormone‐sensitive or metastatic castration‐resistant prostate cancer between 2017 and 2022. We developed an imaging software (Attractive BD_Score) that analyzed whole‐body diffusion‐weighted and in‐phase and opposed‐phase T1‐weighted images to automatically exclude the red bone marrow. The quantified tumor volume was compared with that quantified by traditional whole‐body diffusion‐weighted imaging without red bone marrow exclusion. Prostate‐specific antigen progression‐free survival, time‐to‐pain progression, and overall survival were evaluated to assess the prognostic value of the quantified tumor volume. Results The quantified tumor volume was significantly smaller than that quantified by the traditional method in metastatic hormone‐sensitive (median: 81.0 ml vs. 149.4 ml) and metastatic castration‐resistant (median: 29.4 ml vs. 63.5 ml) prostate cancer. A highly quantified tumor volume was associated with prostate‐specific antigen progression‐free survival (p = 0.030), time‐to‐pain progression (p = 0.003), and overall survival (p = 0.005) in patients with metastatic hormone‐sensitive prostate cancer and with poor prostate‐specific antigen progression‐free survival (p = 0.001) and time‐to‐pain progression (p = 0.005) in patients with metastatic castration‐resistant prostate cancer. Conclusions Our imaging method could accurately quantify the tumor volume in patients with metastatic prostate cancer. The quantified tumor volume can be clinically applied as a new prognostic biomarker for metastatic prostate cancer.

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Section: Discussionmentioning

confidence: 85%

Novel quantitative software for automatically excluding red bone marrow on whole‐body magnetic resonance imaging in patients with metastatic prostate cancer: A pilot study

et al. 2022

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“…Our model was based on a previous classification of bone metastatic sites ( Suzuki et al, 2021 ) and classified metastasis into six sites: skull; cervical, thoracic, and lumbar vertebrae; chest (ribs and sternum); pelvis; upper limbs; and lower limbs. We calculated the bone metastatic score (BMS) for each site as follows: 0 points were assigned for non-metastasis and 1 point was assigned for metastasis.…”

Section: Methodsmentioning

confidence: 99%

“…While these risk stratification models were developed using different clinical endpoints, such as survival rate and disease progression, many investigators demonstrated that these risk stratifications are effective predictors of TTCRPC after primary ADT-based therapy ( Kawahara et al, 2020 ; Mandhani et al, 2016 ; Lin et al, 2019 ). However, they exhibit internal heterogeneity and may have poor sensitivity and specificity ( Suzuki et al, 2021 ; Kanesaka et al, 2021 ; Yamada et al, 2020 ). Moreover, they do not fully evaluate the impact of different bone metastasis sites ( Suzuki et al, 2021 ), which could be a strong predictor of TTCRPC among patients with mHSPC.…”

Section: Introductionmentioning

confidence: 99%

“…However, they exhibit internal heterogeneity and may have poor sensitivity and specificity ( Suzuki et al, 2021 ; Kanesaka et al, 2021 ; Yamada et al, 2020 ). Moreover, they do not fully evaluate the impact of different bone metastasis sites ( Suzuki et al, 2021 ), which could be a strong predictor of TTCRPC among patients with mHSPC.…”

Section: Introductionmentioning

confidence: 99%

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Development and validation of a novel risk model in newly diagnosed de novo bone metastatic prostate cancer (M1b): a retrospective study

Zhang

Wang

Ding

et al. 2023

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Background Previous studies suggested that bone metastasis has a significant effect on the time of progression to metastatic castration-resistant prostate cancer (CRPC) for newly diagnosed de novo bone metastatic hormone-sensitive prostate cancer (mHSPC). Nevertheless, the effect of different bone metastasis sites was not fully evaluated. This study aimed to develop and validate a novel bone metastatic risk model. Methods We enrolled 122 patients who were newly diagnosed with de novo bone metastatic prostate cancer following primary androgen deprivation based therapy at our institution from January 2008 to June 2021. The metastatic bone sites were classified into six sites: skull; cervical, thoracic, and lumbar vertebrae; chest (ribs and sternum); pelvis; upper limbs; and lower limbs. We calculated the bone metastatic score (BMS) for each site: 0 points were assigned for non-metastasis and 1 point was assigned for metastasis. The X-tile was adopted to acquire optimal cutoff points of BMS. We defined high-risk group (HRG) as BMS ≥ 3 and low-risk group (LRG) as BMS < 3. The new bone risk stratification was validated by calculating the area under the receiver operating characteristic curve (AUC). Subsequently, the relevant clinical prognostic variables were added to construct a predictive nomogram for predicting CRPC. Results The median patient age was 73 years. Most patients had Gleason score ≤8 (93 cases, 76.2%). The median follow-up duration was 11.5 months (range: 2–92 months). Eighty-six patients progressed to CRPC during the follow-up. The most common bone metastatic site was the pelvis (90.2%). The median BMS was 4. Seventy-six patients had HRG, while forty-six had LRG. The 1-, 2-, and 3-year AUCs for H/LRG were 0.620, 0.754, and 0.793, respectively. The HRG was associated with earlier time to CRPC. A nomogram based on four parameters (Gleason score, H/LRG, prostate-specific antigen [PSA] nadir, and time to PSA nadir) was developed to predict CRPC. Internal validation using bootstrapping demonstrated good accuracy for predicting the CRPC (C-index: 0.727). The calibration analysis demonstrated that the model performed well. Conclusion We established a novel H/LRG risk model for newly diagnosed de novo bone metastatic prostate cancer, which provided evidence to support clinical decision-making.

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“…The most common metastatic site of PCa is the bone. The prognosis of bone metastases in different sites and the number of bone metastases varies greatly ( Suzuki et al, 2021 ). Soloway et al (1988) proposed an extent of disease (EOD) grading system for patients with mHSPC treated with ADT, which was based on the number of bone metastases detected on bone scans; in this system, the patients were classified into five groups according to tumor grade: Grade 0 = normal imaging findings or imaging appearance of benign bone disease; Grade 1 < 6 bone metastases, with each metastasis involving less than 50% of the vertebral body (bone lesions more than 50% of the vertebral body were counted as two lesions); Grade 2 = 6–20 bone metastases; Grade 3 = lesion size >20 but less than a “super scan”; and Grade 4 = “super scan” or involvement of more than 75% of the ribs and vertebrae.…”

Section: Introductionmentioning

confidence: 99%

Retrospective validation of bone risk stratification criteria for men with de novo metastatic hormone-naive prostate cancer in China

Zhang

Ding

Zheng

et al. 2023

PeerJ

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Background Bone metastasis has been suggested to be a significant impactor on the prognosis of newly diagnosed de novo metastatic hormone-sensitive prostate cancer (mHSPC), and some risk stratification models have been proposed on the basis of this hypothesis. However, the effectiveness of these risk stratification criteria has not been fully evaluated in China. This study aimed to evaluate the effectiveness of the risk stratification models in China. Methods A total of 140 patients who were newly diagnosed with metastatic prostate cancer followed by primary androgen deprivation-based therapy from January 2008 to June 2021 at our institution were enrolled in this study. The patients were divided into different groups on the basis of high- and low-volume disease (H/LVD) criteria, high-and low-risk disease (H/LRD) criteria, extremity bone metastasis criteria (EBM), and extent of disease (EOD) criteria. The area under the receiver operating characteristic (ROC) curve (AUC) and decision curve analysis (DCA) were used to compare the validity and net benefit of these models. Using the Cox proportional hazards model, we performed univariable and multivariable analyses of the factors influencing overall survival (OS) and the time of progression to metastatic castration-resistant prostate cancer (CRPC). Results The median patient age was 72 years. Most patients had a Gleason score ≥8 (102 cases, 72.9%) and clinical T stage >2 (75 cases, 53.6%). The median follow-up time was 25 months (range, 2–95 months). Ninety-two patients progressed to CRPC and fifty-seven patients died during the follow-up. The AUC of OS and CRPC showed that the EOD model had higher validity than the other risk stratification models. DCA shows that the net benefit of the EOD model on OS was better than that of the other risk stratification models. As for CRPC, the net benefit of the EOD model was second only to that of the H/LRD model when the threshold was <0.5; however, when the threshold was >0.5, the EOD model outperformed the other models. The effectiveness of EOD as an independent prognostic variable was verified through univariable and multivariable analyses. Conclusion The EOD model yields reasonable risk stratification for use in Chinese mHSPC patients, providing further evidence supporting its role in clinical decision-making.

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Prognostic impact of bone metastatic volume beyond vertebrae and pelvis in patients with metastatic hormone-sensitive prostate cancer

Cited by 7 publications

References 29 publications

Novel quantitative software for automatically excluding red bone marrow on whole‐body magnetic resonance imaging in patients with metastatic prostate cancer: A pilot study

Novel quantitative software for automatically excluding red bone marrow on whole‐body magnetic resonance imaging in patients with metastatic prostate cancer: A pilot study

Development and validation of a novel risk model in newly diagnosed de novo bone metastatic prostate cancer (M1b): a retrospective study

Retrospective validation of bone risk stratification criteria for men with de novo metastatic hormone-naive prostate cancer in China

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