Visceral Metastases Predict Overall PC Survival in Veterans

by U.S. Medicine

September 18, 2017

DURHAM, NC—Visceral metastases (VMs) are generally believed to predict worse prognoses compared with bone and lymph metastases in men with metastatic castration-resistant prostate cancer (mCRPC).

Still, a new study published in the journal European Urology Focus pointed out that not much is known about what predicts VMs and the extent to which men with VMs do worse.1

A study team led by researchers from the Durham, NC, VAMC sought to determine whether men with VMs at initial mCRPC diagnosis have worse overall survival (OS and then to identify predictors of VMs.:

To do that, they analyzed the cases of 494 men diagnosed with castration-resistant prostate cancer post-1999 and no known metastases who later developed metastases. Records were used from five VA hospitals of the Shared Equal Access Regional Cancer Hospital (SEARCH) database.

Radiology scans within 30 days of initial metastasis diagnosis were reviewed to collect information on bone, visceral, and lymph node metastases, and analysis was performed on the 236 cases where a computed tomography scan had been performed.

Of the 236 mCRPC patients, 16% had VMs. In terms of VMs, results indicate that 19 patients (50%), 8 patients (21%), and 16 patients (42%) had metastases in the liver, lungs, and other locations, respectively.

The study determined that VMs were a predictor of OS on crude analysis (hazard ratio [HR]: 1.88) and after risk adjustment (HR: 1.84). Significant in predicting survival were age, year, treatment center, prostate-specific antigen (PSA), and time from CRPC to metastases, although none of the variables tested were associated with having VMs.

“Demographic, tumor and PSA kinetic characteristics were not predictive of having VMs, but VMs predicted worse OS,” study authors concluded, calling for more research to develop better biomarkers to diagnose VMs at earlier stages in the disease course.

Whitney CA, Howard LE, Posadas EM, Amling CL, Aronson WJ, et. al. In Men with Castration-Resistant Prostate Cancer, Visceral Metastases Predict Shorter Overall Survival: What Predicts Visceral Metastases? Results from the SEARCH Database. Eur Urol Focus. 2016 Aug 29. pii: S2405-4569(16)30115-8. doi: 10.1016/j.euf.2016.08.007. [Epub ahead of print] PubMed PMID: 28753787.


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