Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2020; 8(1): 54-67
Published online Jan 6, 2020. doi: 10.12998/wjcc.v8.i1.54
Prognostic factors for overall survival in prostate cancer patients with different site-specific visceral metastases: A study of 1358 patients
Peng-Fei Cui, Xiao-Feng Cong, Feng Gao, Jia-Xin Yin, Zi-Ru Niu, Song-Chen Zhao, Zi-Ling Liu
Peng-Fei Cui, Xiao-Feng Cong, Feng Gao, Jia-Xin Yin, Zi-Ru Niu, Song-Chen Zhao, Zi-Ling Liu, Cancer Center, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Author contributions: Cui PF acquired and analyzed the data and drafted the manuscript; Cong XF analyzed the data and revised the manuscript; Liu ZL designed the study; Gao F and Yin JX acquired the data; Niu ZR and Zhao SC analyzed the data.
Supported by Department of Science and Technology of Jilin Province, No. 20170623009TC; Jilin Province Development and Reform Commission, No. 3J117B963428.
Institutional review board statement: The study was approved by the ethics committee of the First Hospital of Jilin University.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Zi-Ling Liu, PhD, Professor, Cancer Center, the First Hospital of Jilin University, 71 Xinmin Ave, Changchun 130021, Jilin Province, China. jdyyzlzx999@126.com
Received: October 19, 2019
Peer-review started: October 19, 2019
First decision: November 11, 2019
Revised: December 9, 2019
Accepted: December 14, 2019
Article in press: December 14, 2019
Published online: January 6, 2020
Abstract
BACKGROUND

Distant metastasis, particularly visceral metastasis (VM), represents an important negative prognostic factor for prostate cancer (PCa) patients. However, due to the lower rate of occurrence of VM, studies on these patients are relatively rare. Consequently, studies focusing on prognostic factors associated with PCa patients with VM are highly desirable.

AIM

To investigate the prognostic factors for overall survival (OS) in PCa patients with lung, brain, and liver metastases, respectively, and evaluate the impact of site-specific and number-specific VM on OS.

METHODS

Data on PCa patients with VM were extracted from the Surveillance, Epidemiology, and End Results database between 2010 and 2015. Univariate and multivariate Cox regression analyses were used to analyze the association between clinicopathological characteristics and survival of patients with different site-specific VM. Kaplan-Meier analyses and Log-rank tests were performed to analyze the differences among the groups.

RESULTS

A total of 1358 PCa patients with site-specific VM were identified from 2010 to 2015. Older age (> 70 years) (P < 0.001), higher stage (T3/T4) (P = 0.004), and higher Gleason score (> 8) (P < 0.001) were found to be significant independent prognostic factors associated with poor OS in PCa patients with lung metastases. Higher stage (T3/T4) (P = 0.047) was noted to be the only independent risk factor affecting OS in PCa patients with brain metastases. Older age (> 70 years) (P = 0.010) and higher Gleason score (> 8) (P = 0.001) were associated with shorter OS in PCa patients with liver metastases. PCa patients with isolated lung metastases exhibited significantly better survival outcomes compared with PCa patients with other single sites of VM (P < 0.001). PCa patients with a single site of VM exhibited a superior OS compared with PCa patients with multiple sites of VM (P < 0.001).

CONCLUSION

This is the first Surveillance, Epidemiology, and End Results-based study to determine prognostic factors affecting OS in PCa patients with different site-specific VM. Clinical assessments of these crucial prognostic factors become necessary before establishing a treatment strategy for these patients with metastatic PCa.

Keywords: Prognostic factors, Overall survival, Prostate cancer, Visceral metastases

Core tip: Our study was the first Surveillance, Epidemiology, and End Results-based study to determine prognostic factors affecting overall survival in prostate cancer (PCa) patients with different site-specific visceral metastases. For PCa patients with lung metastases, older age, advanced T stage, and higher Gleason score were independent prognostic factors for overall survival. For PCa patients with liver metastases, older age and higher Gleason score were the significant independent prognostic factors affecting survival rates, while only the advanced T stage was found to be an independent prognostic factor for PCa patients with brain metastases in our study.