Prognostic factors for overall survival in prostate cancer patients with different site-specific visceral metastases: A study of 1358 patients

doi:10.12998/wjcc.v8.i1.54

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World Journal of Clinical Cases

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Clin Cases. Jan 6, 2020; 8(1): 54-67
Published online Jan 6, 2020. doi: 10.12998/wjcc.v8.i1.54

Table 1 Clinicopathological characteristics of 1358 prostate cancer patients with visceral metastases

Variable		n (%)
Marital status	Married	981 (72.2)
	Never married	303 (22.3)
	Unknown	74 (5.4)
Age (yr)	≤ 70	698 (51.4)
Age (yr)	> 70	660 (48.6)
Race	Black	305 (22.5)
	White	962 (70.8)
	Other	87 (6.4)
	Unknown	4 (0.3)
Grade	I/II	52 (3.8)
	III/IV	665 (49.0)
	Unknown	641 (47.2)
T stage	T1/T2	520 (38.3)
	T3/T4	344 (25.3)
	Unknown	494 (36.4)
N stage	N0	586 (43.2)
	N1	442 (32.5)
	Unknown	330 (24.3)
PSA (ng/mL)	≤ 10	136 (10.0)
	> 10	1021 (75.2)
	Unknown	201 (14.8)
Gleason score	≤ 8	307 (22.6)
	9	280 (20.6)
	10	76 (5.6)
	Unknown	695 (51.2)
Bone metastases	No	280 (20.6)
	Yes	1071 (78.9)
	Unknown	7 (0.5)
Number of metastatic sites	1	1154 (85.0)
Number of metastatic sites	> 1	204 (15.0)

Table 2 Patterns and frequencies of visceral metastases

Number of sites of visceral metastases	n
One	1154
Lung	733
Brain	94
Liver	327
Two	187
Lung + Brain	24
Lung + Liver	158
Liver + Brain	5
Three	17
Lung + Brain + Liver	17

Table 3 Univariate and multivariable Cox regression analyses of prognostic factors affecting overall survival in prostate cancer patients with a single site of visceral metastasis

Variable	Univariate analysis			Multiple analysis
Variable	HR	95%CI	P value	HR	95%CI	P value
Marital status
Married	Ref.
Never married	1.030	0.873-1.215	0.726
Unknown	NA	NA	NA
Age (yr)
≤ 70	Ref.			Ref.
> 70	1.557	1.353-1.792	< 0.001	1.593	1.265-2.007	< 0.001
Race
Black	Ref.
White	1.140	0.963-1.351	0.129
Other	0.788	0.565-1.100	0.162
Unknown	NA	NA	NA
Grade¹
I/II	Ref.			Ref.
III/IV	1.577	1.005-2.473	0.047	1.125	0.642-1.973	0.681
Unknown	NA	NA	NA	NA	NA	NA
T stage
T1/T2	Ref.			Ref.
T3/T4	1.239	1.034-1.486	0.020	1.025	0.799-1.314	0.849
Unknown	NA	NA	NA	NA	NA	NA
N stage
N0	Ref.
N1	1.162	0.988-1.368	0.070
Unknown	NA	NA	NA
PSA (ng/mL)
≤ 10	Ref.
> 10	0.887	0.698-1.129	0.331
Unknown	NA	NA	NA
Gleason score
≤ 8	Ref.			Ref.
> 8	1.736	1.401-2.151	< 0.001	1.609	1.260-2.055	< 0.001
Unknown	NA	NA	NA	NA	NA	NA
Bone metastases
No	Ref.			Ref.
Yes	1.282	1.071-1.534	0.007	1.406	1.053-1.877	0.021
Unknown	NA	NA	NA	NA	NA	NA
Lung	Ref.			Ref.
Brain	1.548	1.209-1.983	0.001	1.257	0.778-2.029	0.350
Liver	1.682	1.444-1.959	< 0.001	1.857	1.460-2.361	< 0.001

¹I: Well differentiated; II: Moderately differentiated; III: Poorly differentiated; IV: Undifferentiated. All variables with Unknown Data did not fit in Cox and Kaplan–Meier model. NA: Not available; PSA: Prostate-specific antigen.

Table 4 Univariate and multivariable Cox regression analyses of prognostic factors affecting overall survival in prostate cancer patients with multiple sites of visceral metastasis

Variable	Univariate analysis			Multivariable analysis
Variable	HR	95%CI	P value	HR	95%CI	P value
Marital status
Married	Ref.
Never married	0.817	0.536-1.246	0.348
Unknown	NA	NA	NA
Age (yr)
≤ 70	Ref.			Ref.
> 70	1.545	1.137-2.101	0.005	2.354	1.337-4.145	0.003
Race
Black	Ref.
White	0.964	0.649-1.430	0.855
Other	1.178	0.577-2.406	0.653
Unknown	NA	NA	NA
Grade¹
I/II	Ref.
III/IV	1.607	0.587-4.399	0.356
Unknown	NA	NA	NA
T stage
T1/T2	Ref.			Ref.
T3/T4	2.127	1.410-3.208	< 0.001	2.086	1.203-3.617	0.009
Unknown	NA	NA	NA	NA	NA	NA
N stage
N0	Ref.
N1	0.936	0.648-1.352	0.724
Unknown	NA	NA	NA
PSA (ng/mL)
≤ 10	Ref.
> 10	0.763	0.496-1.173	0.218
Unknown	NA	NA	NA
Gleason score
≤ 8	Ref.			Ref.
> 8	1.713	1.073-2.735	0.024	2.203	1.243-3.905	0.007
Unknown	NA	NA	NA	NA	NA	NA
No	Ref.
Yes	0.827	0.569-1.203	0.321
Unknown	NA	NA	NA

¹I: Well differentiated; II: Moderately differentiated; III: Poorly differentiated; IV: Undifferentiated. All variables with Unknown Data did not fit to Cox and Kaplan–Meier model. NA: Not available; PSA: Prostate-specific antigen.

Table 5 Univariate and multivariate Cox regression analyses of prognostic factors affecting overall survival in prostate cancer patients with visceral metastases

Variable	Univariate analysis			Multivariate analysis
Variable	HR	95%CI	P value	HR	95%CI	P value
Marital status
Married	Ref.
Never married	0.984	0.844-1.147	0.838
unknown	NA	NA	NA
Age (yr)
≤ 70	Ref.			Ref.
> 70	1.543	1.358-1.753	< 0.001	1.672	1.353-2.065	< 0.001
Race
Black	Ref.
White	1.130	0.967-1.320	0.125
Other	0.838	0.620-1.134	0.252
Unknown	NA	NA	NA
Grade¹
I/II	Ref.			Ref.
III/IV	1.586	1.052-2.392	0.028	1.158	0.695-1.927	0.573
Unknown	NA	NA	NA	NA	NA	NA
T stage
T1/T2	Ref.			Ref.
T3/T4	1.352	1.147-1.594	< 0.001	1.236	0.990-1.543	0.061
Unknown	NA	NA	NA	NA	NA	NA
N stage
N0	Ref.
N1	1.143	0.985-1.327	0.078
Unknown	NA	NA	NA
PSA (ng/mL)
≤ 10	Ref.
> 10	0.836	0.678-1.030	0.092
Unknown	NA	NA	NA
Gleason score
≤ 8	Ref.			Ref.
> 8	1.710	1.407-2.077	< 0.001	1.636	1.308-2.047	< 0.001
Unknown	NA	NA	NA	NA	NA	NA
Bone metastases
No	Ref.			Ref.
Yes	1.205	1.025-1.417	0.024	1.323	1.019-1.716	0.035
Unknown	NA	NA	NA	NA	NA	NA
1	Ref.			Ref.
> 1	1.446	1.222-1.712	< 0.001	1.850	1.396-2.451	< 0.001

Table 6 Univariate Cox regression analysis of prognostic factors affecting overall survival in prostate cancer patients with lung, brain, and liver metastases

Variable	Lung			Brain			Liver
Variable	HR	95%CI	P value	HR	95%CI	P value	HR	95%CI	P value
Marital status
Married	Ref.			Ref.			Ref.
Never married	0.924	0.757-1.127	0.436	1.169	0.738-1.853	0.506	0.950	0.754-1.198	0.667
Unknown	NA	NA	NA	NA	NA	NA	NA	NA	NA
Age (yr)
≤ 70	Ref.			Ref.			Ref.
> 70	1.728	1.471-2.029	< 0.001	1.502	1.025-2.202	0.037	1.349	1.111-1.637	0.003
Race
Black	Ref.			Ref.			Ref.
White	1.078	0.888-1.310	0.447	1.130	0.685-1.865	0.632	1.130	0.892-1.432	0.310
Other	0.824	0.572-1.187	0.299	1.562	0.652-3.741	0.317	0.923	0.568-1.499	0.745
Unknown	NA	NA	NA	NA	NA	NA	NA	NA	NA
Grade¹
I/II	Ref.			Ref.			Ref.
III/IV	2.063	1.098-3.877	0.024	2.416	0.741-7.874	0.144	1.332	0.788-2.253	0.284
Unknown	NA	NA	NA	NA	NA	NA	NA	NA	NA
T stage
T1/T2	Ref.			Ref.			Ref.
T3/T4	1.476	1.203-1.811	< 0.001	1.786	1.015-3.145	0.044	1.318	1.033-1.681	0.026
Unknown	NA	NA	NA	NA	NA	NA	NA	NA	NA
N stage
N0	Ref.			Ref.			Ref.
N1	1.136	0.942-1.368	0.182	0.957	0.587-1.559	0.859	1.128	0.903-1.410	0.289
Unknown	NA	NA	NA	NA	NA	NA	NA	NA	NA
PSA (ng/mL)
≤ 10	Ref.			Ref.			Ref.
> 10	0.779	0.603-1.005	0.055	1.506	0.752-3.017	0.248	0.781	0.581-1.049	0.101
Unknown	NA	NA	NA	NA	NA	NA	NA	NA	NA
Gleason score
≤ 8	Ref.			Ref.			Ref.
> 8	1.848	1.446-2.361	< 0.001	1.322	0.661-2.643	0.430	1.533	1.154-2.036	0.003
Unknown	NA	NA	NA	NA	NA	NA	NA	NA	NA
Bone metastases
No	Ref.			Ref.			Ref.
Yes	1.246	1.013-1.533	0.038	1.258	0.748-2.115	0.388	1.029	0.817-1.296	0.807
Unknown	NA	NA	NA	NA	NA	NA	NA	NA	NA

Table 7 Multivariable Cox regression analysis of prognostic factors affecting overall survival in prostate cancer patients with lung, brain, and liver metastases

Variable	Lung			Brain			Liver
Variable	HR	95%CI	P value	HR	95%CI	P value	HR	95%CI	P value
Age (yr)
≤ 70	Ref.			Ref.			Ref.
> 70	2.084	1.601-2.712	< 0.001	0.994	0.553-1.785	0.983	1.499	1.099-2.043	0.010
Grade¹
I/II	Ref.
III/IV	2.031	0.879-4.692	0.097
Unknown	NA	NA	NA
T stage
T1/T2	Ref.			Ref.			Ref.
T3/T4	1.490	1.135-1.958	0.004	1.785	1.007-3.163	0.047	1.021	0.737-1.414	0.900
Unknown	NA	NA	NA	NA	NA	NA	NA	NA	NA
Gleason score
≤ 8	Ref.						Ref.
> 8	1.735	1.315-2.289	< 0.001				1.688	1.224-2.327	0.001
Unknown	NA	NA	NA				NA	NA	NA
Bone metastases
No	Ref.
Yes	1.327	0.961-1.833	0.086
Unknown	NA	NA	NA

Citation: Cui PF, Cong XF, Gao F, Yin JX, Niu ZR, Zhao SC, Liu ZL. Prognostic factors for overall survival in prostate cancer patients with different site-specific visceral metastases: A study of 1358 patients. World J Clin Cases 2020; 8(1): 54-67
URL: https://www.wjgnet.com/2307-8960/full/v8/i1/54.htm
DOI: https://dx.doi.org/10.12998/wjcc.v8.i1.54