Mike Wenzel, Benedikt Hoeh, Clara Humke, Florestan Koll, Cristina Cano Garcia, Carolin Siech, Thomas Steuber, Markus Graefen, Miriam Traumann, Luis Kluth, Felix K H Chun, Philipp Mandel
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Endpoints were PFS and OS in uni- and multivariable Cox regression models.</p><p><strong>Results: </strong>Of 363 patients, 9.4% harbored M1a vs. 78% M1b vs. 12% M1c mCRPC with significantly higher PSA in M1b (9 vs. 22 vs. 8ng/ml). Rates of DeNovo (15% vs. 60% vs. 56%) were significantly lower in the M1a mCRPC group, compared to M1b and M1c (p < 0.001). In PFS analyses, a median of 12.7 vs. 10.1 vs. 15.9 months for M1a vs. M1b vs. M1c mCRPC was observed (p > 0.05). In multivariable Cox regression models, M1c mCRPC was independently at higher risk for progression (hazard ratio [HR]: 5.93, p = 0.048), relative to M1a. Regarding OS, significant differences were observed (p = 0.002), with median OS of 58 vs. 42 vs. 25 months for M1a vs. M1b vs. M1c mCRPC and corresponding HRs of 1.54 (p = 0.11) and 2.76 (p < 0.01). In multivariable models M1c mCRPC was associated with higher risk of death (HR: 3.56, p = 0.049), relative to M1a. No differences were observed after stratification according to number of bone lesions (all p ≥ 0.05).</p><p><strong>Conclusion: </strong>M1c mCRPC patients are independently at higher risk for progression and death, while M1a patients harbor best cancer-control outcomes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531415/pdf/","citationCount":"0","resultStr":"{\"title\":\"Influence of metastatic sites and burden on oncological outcomes in patients progressing to metastatic castration resistant prostate cancer.\",\"authors\":\"Mike Wenzel, Benedikt Hoeh, Clara Humke, Florestan Koll, Cristina Cano Garcia, Carolin Siech, Thomas Steuber, Markus Graefen, Miriam Traumann, Luis Kluth, Felix K H Chun, Philipp Mandel\",\"doi\":\"10.1007/s00345-024-05341-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Metastatic castration-resistant prostate cancer (mCRPC) patients harbor reduced life expectancy after first-line treatment progression. Currently, no information is available regarding the influence of metastatic sites and osseous burden on progression-free (PFS) and overall survival (OS) of mCRPC patients.</p><p><strong>Methods: </strong>We relied on the Frankfurt Metastatic Cancer Database of the Prostate (FRAMCAP) database to select patients progressing to mCRPC and stratified them according to lymph node vs. osseous vs. visceral metastatic sites. Moreover, we stratified osseous mCRPC patients regarding the number of metastatic lesions. Endpoints were PFS and OS in uni- and multivariable Cox regression models.</p><p><strong>Results: </strong>Of 363 patients, 9.4% harbored M1a vs. 78% M1b vs. 12% M1c mCRPC with significantly higher PSA in M1b (9 vs. 22 vs. 8ng/ml). Rates of DeNovo (15% vs. 60% vs. 56%) were significantly lower in the M1a mCRPC group, compared to M1b and M1c (p < 0.001). In PFS analyses, a median of 12.7 vs. 10.1 vs. 15.9 months for M1a vs. M1b vs. M1c mCRPC was observed (p > 0.05). In multivariable Cox regression models, M1c mCRPC was independently at higher risk for progression (hazard ratio [HR]: 5.93, p = 0.048), relative to M1a. Regarding OS, significant differences were observed (p = 0.002), with median OS of 58 vs. 42 vs. 25 months for M1a vs. M1b vs. M1c mCRPC and corresponding HRs of 1.54 (p = 0.11) and 2.76 (p < 0.01). In multivariable models M1c mCRPC was associated with higher risk of death (HR: 3.56, p = 0.049), relative to M1a. 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引用次数: 0
摘要
目的：转移性抗性前列腺癌（mCRPC）患者在一线治疗进展后预期寿命缩短。目前，还没有关于转移部位和骨性负担对mCRPC患者无进展生存期（PFS）和总生存期（OS）的影响的信息：我们依靠法兰克福前列腺癌转移数据库（FRAMCAP）筛选出进展为mCRPC的患者，并根据淋巴结转移部位、骨转移部位和内脏转移部位对他们进行了分层。此外，我们还根据转移病灶的数量对骨性 mCRPC 患者进行了分层。在单变量和多变量考克斯回归模型中，终点为PFS和OS：在363名患者中，9.4%患有M1a，78%患有M1b，12%患有M1c，其中M1b患者的PSA明显更高（9 vs. 22 vs. 8ng/ml）。与M1b和M1c相比，M1a mCRPC组的DeNovo率（15% vs. 60% vs. 56%）明显较低（P 0.05）。在多变量Cox回归模型中，相对于M1a，M1c mCRPC的进展风险更高（危险比[HR]：5.93，P = 0.048）。M1a与M1b与M1c mCRPC的中位OS分别为58个月与42个月与25个月，相应的HR分别为1.54（P = 0.11）和2.76（P 结论：M1a与M1b与M1c mCRPC的中位OS分别为58个月与42个月与25个月，相应的HR分别为1.54（P = 0.11）和2.76（P = 0.002）：M1c型mCRPC患者的病情恶化和死亡风险较高，而M1a型患者的癌症控制效果最好。
Influence of metastatic sites and burden on oncological outcomes in patients progressing to metastatic castration resistant prostate cancer.
Purpose: Metastatic castration-resistant prostate cancer (mCRPC) patients harbor reduced life expectancy after first-line treatment progression. Currently, no information is available regarding the influence of metastatic sites and osseous burden on progression-free (PFS) and overall survival (OS) of mCRPC patients.
Methods: We relied on the Frankfurt Metastatic Cancer Database of the Prostate (FRAMCAP) database to select patients progressing to mCRPC and stratified them according to lymph node vs. osseous vs. visceral metastatic sites. Moreover, we stratified osseous mCRPC patients regarding the number of metastatic lesions. Endpoints were PFS and OS in uni- and multivariable Cox regression models.
Results: Of 363 patients, 9.4% harbored M1a vs. 78% M1b vs. 12% M1c mCRPC with significantly higher PSA in M1b (9 vs. 22 vs. 8ng/ml). Rates of DeNovo (15% vs. 60% vs. 56%) were significantly lower in the M1a mCRPC group, compared to M1b and M1c (p < 0.001). In PFS analyses, a median of 12.7 vs. 10.1 vs. 15.9 months for M1a vs. M1b vs. M1c mCRPC was observed (p > 0.05). In multivariable Cox regression models, M1c mCRPC was independently at higher risk for progression (hazard ratio [HR]: 5.93, p = 0.048), relative to M1a. Regarding OS, significant differences were observed (p = 0.002), with median OS of 58 vs. 42 vs. 25 months for M1a vs. M1b vs. M1c mCRPC and corresponding HRs of 1.54 (p = 0.11) and 2.76 (p < 0.01). In multivariable models M1c mCRPC was associated with higher risk of death (HR: 3.56, p = 0.049), relative to M1a. No differences were observed after stratification according to number of bone lesions (all p ≥ 0.05).
Conclusion: M1c mCRPC patients are independently at higher risk for progression and death, while M1a patients harbor best cancer-control outcomes.
期刊介绍：
The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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