Abstract
PurposeOur study aims to examine the impact of definitive local therapy in prostate cancer patients with different metastatic sites.MethodsTotally, 5,849 patients diagnosed with metastatic prostate carcinoma from 2010 to 2014 were selected from Surveillance, Epidemiology, and End Results (SEER). Log-rank analyses, multivariable regression analysis, and Kaplan–Meier methods were used to assess prognostic impact of local treatment in patients with different metastatic sites. Survival curves and forest plots were also plotted to describe the prognostic value of definitive local therapy.ResultsIn our study, 159 patients received radical prostatectomy, and 62 received brachytherapy, while 5,628 did not receive local definitive local therapy. Survival analysis revealed that patients who received definitive local therapy had a better 5-year overall survival (OS) (P = 0.011) and cancer-specific survival (CSS) (P = 0.012). Multivariate regression analyses demonstrated that type of treatment was an independent prognostic indicator for OS (P = 0.011) and CSS (P = 0.012), along with age at diagnosis, chemotherapy, PSA level, and Gleason score. According to subgroup analysis, patients with bone metastasis or distant lymph node (LN) metastasis were significantly more likely to benefit from definitive local therapy. In addition, forest plots demonstrated that RP group had significant favorable OS and CSS in subgroups of younger age at diagnosis, T2–3 stage, N0–1 stage, Gleason score =7 or ≥8, bone metastasis, and distant LN metastasis.ConclusionsOur study suggested that local therapy improved survival in prostate cancer patients with bone or distant LN metastasis. Furthermore, patients who were at T2–3 stage or Gleason score ≥7 also significantly benefit from definitive local therapy.
Highlights
Prostate carcinoma is one of the most common cancers in men [1]
No significant difference in M stage, chemotherapy, brain, liver, lung, and distant lymph nodes (LNs) metastasis was noted among the groups
In our study, using the metastatic prostate cancer cohort from the SEER database, we retrospectively studied the effect of local treatment in prostate cancer patients with different sites of metastasis and proved that definitive local therapy improved survival in patients with bone or LN metastasis
Summary
Prostate carcinoma is one of the most common cancers in men [1]. In 2016, it is estimated that more than three million men were currently prostate cancer patients in the United States, and many of them were diagnosed with metastasis [2]. The prognosis of metastatic prostate cancer was comparatively poor, which caused significant mortality in prostate cancer patients [3]. Several studies have studied the distribution of metastatic sites in prostate cancer patients, and the most common ones were distant lymph nodes (LNs) and bones [4]. Shou et al reported that patients with different metastatic sites seemed to have significant different prognosis in prostate cancer, which might have promising implications to make different clinical decisions to those patients [6]
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