Clinical genitourinary cancer · 2025
Metastatic Prostate Cancer with Low-Volume Primary Tumors - A National Cancer Database Analysis on Metastasis Profile and Survival Outcomes.
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Raja Iyub Mohamed Javid, Prabhakar Pushan, Sakthivel Deerush Kannan, Chandrasekaran Aditi, Garje Rohan, Manoharan Murugesan
Аннотация
INTRODUCTION: A tumor confined within the prostate gland is termed localized prostate cancer (PCa). However, metastasis could rarely develop in such low-volume primary tumors. The nature of these metastatic prostate cancers with low-volume primary tumors is largely underexplored. The objective of our study was to analyze the baseline characteristics, metastatic patterns, and survival outcomes of this condition from the National Cancer Database (NCDB).
METHODS: Data from patients diagnosed with metastatic prostate cancer with low-volume primary tumors between 2004 and 2021 were analyzed for patient characteristics, metastatic trends, variations by histopathology type, and survival outcomes. Multivariable logistic regression was used to identify various factors associated with this condition. Survival outcomes were evaluated using the Kaplan-Meier analysis.
RESULTS: A total of 1,613,004 individuals diagnosed with clinically localized PCa were analyzed. Among them, 45,010 patients had distant metastasis. The most common site of metastasis was bone, followed by lung, liver, and brain. The most common histopathology type was adenocarcinoma (94.3%). The median overall survival (OS) of metastatic prostate cancer with low-volume primary tumors was 37.13 (95% Confidence Interval (CI), 36.57-37.68) months. The best OS in single-site metastasis was seen in lung metastasis (median OS: 54.34 [95% CI, 42.10-66.58] months), and the worst was seen in liver metastasis (median OS: 18.17 [95% CI, 12.70-23.63] months). Adenocarcinoma had a better prognosis (median OS: 38.51 [95% CI, 37.91-39.10] months) than non-adenocarcinoma (median OS: 17.58 [95% CI, 16.40-18.75] months). All results had a P-value less than .001.
CONCLUSION: This comprehensive analysis reveals that metastatic prostate cancer with low-volume primary tumors is relatively uncommon (2.8% of ≤ T2 disease), with bone being the most common metastatic site. Isolated metastasis in the lungs and adenocarcinoma had better OS among the metastasis sites and histopathology type, respectively.
METHODS: Data from patients diagnosed with metastatic prostate cancer with low-volume primary tumors between 2004 and 2021 were analyzed for patient characteristics, metastatic trends, variations by histopathology type, and survival outcomes. Multivariable logistic regression was used to identify various factors associated with this condition. Survival outcomes were evaluated using the Kaplan-Meier analysis.
RESULTS: A total of 1,613,004 individuals diagnosed with clinically localized PCa were analyzed. Among them, 45,010 patients had distant metastasis. The most common site of metastasis was bone, followed by lung, liver, and brain. The most common histopathology type was adenocarcinoma (94.3%). The median overall survival (OS) of metastatic prostate cancer with low-volume primary tumors was 37.13 (95% Confidence Interval (CI), 36.57-37.68) months. The best OS in single-site metastasis was seen in lung metastasis (median OS: 54.34 [95% CI, 42.10-66.58] months), and the worst was seen in liver metastasis (median OS: 18.17 [95% CI, 12.70-23.63] months). Adenocarcinoma had a better prognosis (median OS: 38.51 [95% CI, 37.91-39.10] months) than non-adenocarcinoma (median OS: 17.58 [95% CI, 16.40-18.75] months). All results had a P-value less than .001.
CONCLUSION: This comprehensive analysis reveals that metastatic prostate cancer with low-volume primary tumors is relatively uncommon (2.8% of ≤ T2 disease), with bone being the most common metastatic site. Isolated metastasis in the lungs and adenocarcinoma had better OS among the metastasis sites and histopathology type, respectively.