INTRODUCTION

This retrospective study aimed to evaluate the prognostic value of [F]FDG parameters in patients with visceral and bone metastatic hormone-sensitive prostate cancer (mHSPC).

PATIENTS AND METHODS

This analysis included the mHSPC patients who underwent [F]FDG PET/CT at the initial diagnosis. Baseline characteristics were analyzed, and the uptake of [F]FDG was quantified using SUV. Kaplan-Meier and Cox proportional hazard regression analysis were employed to evaluate the correlation between SUV and patient survival.

RESULTS

Among the 267 patients enrolled, 90 (33.7%) presented with visceral metastases and 177 (66.3%) had bone metastases. The median follow-up for the visceral metastasis group was 35.5 months (IQR 26-53.8 months). The median overall survival for patients with lung, liver, or both metastases were 30, 21 and 17 months, respectively. Patients exhibiting higher [F]FDG uptake in metastatic lesions experienced shorter overall survival (OS) in comparison to those with lower [F]FDG uptake, both in the visceral metastases group (17 vs. 31 months,  = 0.002) and the bone metastases group (27.5 vs. 34.5 months,  < 0.001). Cox regression analysis further revealed that increased [F]FDG uptake in metastatic lesions emerged as a significant risk factor in both OS and progression-free survival (PFS). In contrast, the variability in [F]FDG uptake in primary lesions did not provide a reliable indicator for predicting prognosis.

CONCLUSIONS

In mHSPC patients, higher [F]FDG uptake in metastatic lesions indicates shorter survival and increased risk of disease progression. The [F]FDG SUV in primary tumors did not show significant prognostic value. Our study underscores the unique prognostic potential of [F]FDG PET/CT in mHSPC patients, highlighting its importance in the management of both bone and visceral metastases.