Prostate cancer and prostatic diseases · 2025
Progression of index metastases in oligometastatic hormone-sensitive prostate cancer: implications for metastases directed therapy?
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Verma Parth, Maitre Priyamvada, Krishnasamy Gowtham Surya, Murarka Nishika, Choudhury Sayak, Ghosh Suchismita, Agrawal Archi, Murthy Vedang
Аннотация
BACKGROUND: For de-novo oligometastatic prostate cancer (omHSPC) treated with standard of care androgen suppression and prostate radiotherapy, the patterns of progression vis-a-vis index metastatic sites are not well understood.
METHODS: This single-centre study included patients with de-novo omHSPC (CHAARTED criteria) staged with a PSMA-PET/CT scan at diagnosis, treated with systemic therapy and prostate radiotherapy, and re-staged with PSMA-PET/CT at biochemical progression. Disease status at index oligometastases was noted at progression.
RESULTS: From 2015 to 2024, 79 patients with omHSPC were found eligible (M1a = 22, M1b = 57). Over a median follow-up of 39 months (IQR 28-69), 15 patients (19%) had disease progression. Restaging PSMA-PET/CT revealed progression of the index oligometastases for 11/15 patients (73%), with additional metastases in 7 of these.
CONCLUSION: The high proportion of progression at the index oligometastases supports the potential benefit of metastasis-directed therapy for local ablation.
METHODS: This single-centre study included patients with de-novo omHSPC (CHAARTED criteria) staged with a PSMA-PET/CT scan at diagnosis, treated with systemic therapy and prostate radiotherapy, and re-staged with PSMA-PET/CT at biochemical progression. Disease status at index oligometastases was noted at progression.
RESULTS: From 2015 to 2024, 79 patients with omHSPC were found eligible (M1a = 22, M1b = 57). Over a median follow-up of 39 months (IQR 28-69), 15 patients (19%) had disease progression. Restaging PSMA-PET/CT revealed progression of the index oligometastases for 11/15 patients (73%), with additional metastases in 7 of these.
CONCLUSION: The high proportion of progression at the index oligometastases supports the potential benefit of metastasis-directed therapy for local ablation.