根据内脏转移部位对转移性前列腺癌患者进行总生存分析
Overall Survival of Metastatic Prostate Cancer Patients According to Location of Visceral Metastatic Sites.
作者信息
Tappero Stefano, Piccinelli Mattia Luca, Incesu Reha-Baris, Cano Garcia Cristina, Barletta Francesco, Morra Simone, Scheipner Lukas, Baudo Andrea, Tian Zhe, Parodi Stefano, Dell'Oglio Paolo, de Cobelli Ottavio, Graefen Markus, Chun Felix K H, Briganti Alberto, Longo Nicola, Ahyai Sascha, Carmignani Luca, Saad Fred, Shariat Shahrokh F, Suardi Nazareno, Borghesi Marco, Terrone Carlo, Karakiewicz Pierre I
机构信息
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Ospedale Policlinico San Martino, Genova, Italy; Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy.
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.
出版信息
Clin Genitourin Cancer. 2024 Apr;22(2):47-55.e2. doi: 10.1016/j.clgc.2023.08.004. Epub 2023 Aug 11.
INTRODUCTION
It is unknown whether specific locations of visceral metastatic sites affect overall survival (OS) of metastatic prostate cancer (mPCa) patients. We tested the association between specific locations of visceral metastatic sites and OS in mPCa patients.
MATERIALS AND METHODS
Within Surveillance, Epidemiology and End Results database (2010-2016), survival analyses relied on specific locations of visceral metastases: lung only vs. liver only vs. brain only vs. ≥2 visceral sites. Kaplan-Meier plots and Cox regression models were fitted.
RESULTS
Of 1827 patients, 1044 (57%) harbored lung only visceral metastases vs. 457 (25%) liver only vs. 131 (7%) brain only vs. 195 (11%) ≥2 visceral sites. Median OS was 22 months in all patients vs. 33 months in lung only vs. 15 months in liver only vs. 16 months in brain only vs. 15 months in patients with ≥2 visceral sites. Highest OS was recorded in lung only visceral metastases patients, especially when concomitant nonvisceral metastases were located in lymph nodes only (median OS 57 months) vs. bone only (26 months) vs. lymph nodes and bone (28 months). Liver only, brain only or ≥2 visceral sites exhibited poor OS, regardless of concomitant nonvisceral metastases type (median OS from 13 to 19 months).
CONCLUSION
In mPCa patients, lung only visceral metastases, especially when associated with lymph node only nonvisceral metastases, portend the best prognosis. Conversely, visceral metastatic sites other than lung portend poor prognosis, regardless of concomitant nonvisceral metastases type.
引言
内脏转移部位的特定位置是否会影响转移性前列腺癌（mPCa）患者的总生存期（OS）尚不清楚。我们测试了mPCa患者内脏转移部位的特定位置与OS之间的关联。
材料与方法
在监测、流行病学和最终结果数据库（2010 - 2016年）中，生存分析依赖于内脏转移的特定位置：仅肺部转移 vs. 仅肝脏转移 vs. 仅脑部转移 vs. ≥2个内脏部位转移。拟合了Kaplan - Meier曲线和Cox回归模型。
结果
在1827例患者中，1044例（57%）仅有肺部内脏转移，457例（25%）仅有肝脏转移，131例（7%）仅有脑部转移，195例（11%）有≥2个内脏部位转移。所有患者的中位OS为22个月，仅肺部转移患者为33个月，仅肝脏转移患者为15个月，仅脑部转移患者为16个月，≥2个内脏部位转移患者为15个月。仅肺部内脏转移患者的OS最高，尤其是当同时存在的非内脏转移仅位于淋巴结时（中位OS为57个月），而仅位于骨时（26个月），以及位于淋巴结和骨时（28个月）。仅肝脏、仅脑部或≥2个内脏部位转移患者的OS较差，无论同时存在的非内脏转移类型如何（中位OS为13至19个月）。
结论
在mPCa患者中，仅肺部内脏转移，尤其是与仅淋巴结非内脏转移相关时，预示着最佳预后。相反，肺部以外的内脏转移部位预示着预后不良，无论同时存在的非内脏转移类型如何。
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