It is generally accepted that when metastases develop in a patient with biochemical recurrence of prostate cancer (PCa), they follow a centrifuge pattern of seeding from the pelvis and that most patients enter the disease as oligometastatic. In this study, we used whole-body magnetic resonance imaging (WB-MRI) to assess the anatomical distribution of oligo- and polymetastatic disease and the impact of the initial treatment on this distribution in patients.
WB-MRI examinations of patients with a rising prostate-specific antigen (PSA) after radical treatment by surgery or/and radiotherapy were analyzed for disease recurrence. The patients were separated into three groups, based on the primary treatment: patients treated by radical prostatectomy without radiotherapy and with/without lymph node dissection (RP), patients treated only by radiotherapy or hormono-radiotherapy (RT) and patients treated with radical prostatectomy and adjuvant or salvage radiotherapy (RP + RT). Patients with ≤ 5 bone or/and node metastases were considered oligometastatic. Regional distributions of bone and lymph nodes metastases were reported using anatomical diagrams. Univariate and multivariable logistic regressions were performed to identify prognostic factors of relapse.
The primary treatment (RP, RT, RP + RT), Gleason score, PSA at relapse, time between first diagnosis and recurrence did not influence the metastatic status (oligo vs. polymetastatic). Oligometastatic patients showed different distribution of bone metastases compared to the polymetastatic ones and the distribution of the oligometastatic disease was not influenced by the primary treatment.
In this WB-MRI-based study, there was no evidence that the primary treatment influenced the metastatic status of the patient or the distribution of the oligometastatic disease.
World journal of urology. 2019 Mar 02 [Epub ahead of print]
Vassiliki Pasoglou, Nicolas Michoux, Julien Van Damme, Sandy Van Nieuwenhove, Marin Halut, Perrine Triqueneaux, Bertrand Tombal, Frédéric E Lecouvet
Department of Radiology, Centre Du Cancer and Institut de Recherche Expérimentale Et Clinique (IREC, IMAG), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium. ., Department of Radiology, Centre Du Cancer and Institut de Recherche Expérimentale Et Clinique (IREC, IMAG), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium., Department of Urology, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium.