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
ARTICLE HIGHLIGHTS
Research background

Metastases to distant organs may significantly threaten quality of life and survival in men with prostate cancer (PCa). There is sufficient evidence to support that the incidence rates of newly diagnosed metastatic PCa have significantly increased, which is becoming a severe public health concern in the United States.

Research motivation

Bone is the most commonly involved organ in PCa, and substantial studies explore characteristics of PCa patients with liver metastases. However, due to the lower rate of occurrence of visceral metastases (VM), studies on those patients are relatively rare.

Research objectives

To identify the prognostic factors for overall survival (OS) in PCa patients with VM and evaluate the impact of site-specific and number-specific VM on OS.

Research methods

The records of PCa patients with VM in the Surveillance, Epidemiology, and End Results database, diagnosed between 2010 and 2015, were obtained. Cox regression analysis was used to identify the independent prognostic factors. Kaplan-Meier analyses and Log-rank tests were performed to analyze the differences among the groups.

Research results

Older age, higher stage, and higher Gleason score were found to be significant independent prognostic factors associated with a poor OS in PCa patients with lung metastases. Higher stage was noted to be the only independent risk factor affecting OS in PCa patients with brain metastases. Older age and higher Gleason score were associated with a 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. PCa patients with a single site of VM exhibited a superior OS compared with PCa patients with multiple sites of VM.

Research conclusions

Our research identifies prognostic factors affecting OS in PCa patients with different site-specific VM. Patients with lung metastases or with a single site of VM have a better prognosis.

Research perspectives

Special attention should be paid to those patients with poor factors. Clinical assessments of these crucial prognostic factors become necessary before establishing a treatment strategy for these patients with metastatic PCa. However, the type of accessible data through the Surveillance, Epidemiology, and End Results program is limited, and the relationship between other variables such as change of PSA levels during the course of the disease and survival need to be investigated.