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Prognostic factors influencing overall survival in de novo oligometastatic prostate cancer patients
Author(s) -
Rii Junryo,
Sakamoto Shinichi,
Yamada Yasutaka,
Takeshita Nobushige,
Yamamoto Satoshi,
Sazuka Tomokazu,
Imamura Yusuke,
Nakamura Kazuyoshi,
Komiya Akira,
Komaru Atsushi,
Fukasawa Satoshi,
Nakatsu Hiroomi,
Akakura Koichiro,
Ichikawa Tomohiko
Publication year - 2020
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.24016
Subject(s) - medicine , prostate cancer , oncology , hazard ratio , proportional hazards model , lymph node , cancer , androgen deprivation therapy , multivariate analysis , prostate , confidence interval
Background Oligometastatic cancer has been suggested as an intermediate state between localized disease and wide‐ranging metastases. The clinical significance of local treatment in oligometastatic prostate cancer (PCa) has been a recent topic of interest. However, standard definitions of oligometastasis are lacking. Here we studied risk factors among Japanese de novo oligometastatic patients with PCa. Methods We retrospectively assessed clinical data from 264 patients, including locally advanced (T3 or T4N0M0) cancer, lymph‐node‐positive cancer (T any N1M0), and cancer with ≤10 bone metastases. All patients received androgen deprivation therapy only. The number of bone metastases and clinical factors were evaluated in association with overall survival (OS) and progression‐free survival (PFS). The Mann‐Whitney U test, Cox proportional hazard models, and Kaplan‐Meier methods were used as statistical analyses. Results Median age, PSA at baseline and OS were 74 years, 55.2 ng/mL, and 129.0 months, respectively. The cutoff for the number of bone metastases having the greatest impact on OS was ≥3 (hazard ratio [HR]: 2.67; P = .0001). In multivariate analysis, non‐regional lymph node (LN) metastases (HR: 2.15; P = .0222), ISUP grade group (GG) 5 (HR: 2.04; P = .0186) and ≥3 bone metastases (HR: 1.82; P = .0390) were independent predictors of OS. In risk classification based on these factors, OS and PFS were significantly classifiable into poor (2‐3 factors), intermediate (1 factor), and good (no factors) risk groups ( P < .0001). Conclusion Not only the number of bone metastases, but also non‐regional LN metastases predict OS in patients with de novo oligometastatic PCa.