Metastatic burden is a critical factor for therapy decision-making in metastatic hormone-sensitive prostate cancer. This study aimed to identify prognostic factors in men with high or low metastatic burden treated with primary androgen-deprivation therapy. The study included 2450 men with de novo metastatic prostate cancer who were treated with primary androgen-deprivation therapy at 30 institutions across Japan between 2008 and 2017. We investigated the prognostic value of various clinicopathological parameters for progression-free survival (PFS) and overall survival (OS) in patients stratified by low or high metastatic burden. Among the 2450 men, 841 (34.3%) and 1609 (65.7 %) were classified as having low and high metastatic burden, respectively. The median PFS of the low- and high-burden groups were 44.5 and 16.1 months, respectively, and the median OS was 103.2 and 62.7 months, -respectively. Percentage of biopsy positive core, biopsy Gleason grade group, T-stage, and N-stage were identified to be differentially prognostic. M1a was associated with worse PFS than was M1b in the low-burden group, while lung metastasis was associated with better PFS and OS than was M1b in the high-burden group. Differential prognostic factors were identified for patients with low- and high-burden metastatic prostate cancer. These results may assist in decision-making to select the optimal therapeutic strategies for patients with different metastatic burdens.
Cancer science. 2020 Nov 07 [Epub ahead of print]
Masaki Shiota, Naoki Terada, Toshihiro Saito, Akira Yokomizo, Naoki Kohei, Takayuki Goto, Sadafumi Kawamura, Yasuhiro Hashimoto, Atsushi Takahashi, Takahiro Kimura, Ken-Ichi Tabata, Ryotaro Tomida, Kohei Hashimoto, Toshihiko Sakurai, Toru Shimazui, Shinichi Sakamoto, Manabu Kamiyama, Nobumichi Tanaka, Koji Mitsuzuka, Takuma Kato, Shintaro Narita, Hiroaki Yasumoto, Shogo Teraoka, Masashi Kato, Takahiro Osawa, Yoshiyuki Nagumo, Hiroaki Matsumoto, Hideki Enokida, Takayuki Sugiyama, Kentaro Kuroiwa, Takahiro Inoue, Takashi Mizowaki, Toshiyuki Kamoto, Takahiro Kojima, Hiroshi Kitamura, Mikio Sugimoto, Hiroyuki Nishiyama, Masatoshi Eto, Japanese Urological Oncology Group Juog
Department of Urology, Kyushu University, Fukuoka., Department of Urology, Miyazaki University, Miyazaki., Department of Urology, Niigata Cancer Center Hospital, Niigata., Department of Urology, Harasanshin Hospital, Fukuoka., Department of Urology, Shizuoka General Hospital, Shizuoka., Department of Urology, Kyoto University, Kyoto., Department of Urology, Miyagi Cancer Center, Natori., Department of Urology, Hirosaki University, Hirosaki., Department of Urology, Hakodate Goryoukaku Hospital, Hakodate., Department of Urology, Jikei University, Tokyo., Department of Urology, Kitasato University, Sagamihara., Department of Urology, Shikoku Cancer Center, Matsuyama., Department of Urology, Sapporo Medical University, Sapporo., Department of Urology, Yamagata University, Yamagata., Department of Urology, Ibaraki Prefectural Central Hospital, Ibaraki Cancer Center, Kasama., Department of Urology, Chiba University, Chiba., Department of Urology, University of Yamanashi Hospital, Chuo., Department of Urology, Nara Medical University, Kashihara., Department of Urology, Tohoku University, Sendai., Department of Urology, Kagawa University, Kagawa., Department of Urology, Akita University, Akita., Department of Urology, Shimane University, Izumo., Department of Urology, Tottori University, Yonago., Department of Urology, Nagoya University, Nagoya., Department of Renal and Genitourinary Surgery, Hokkaido University, Sapporo., Department of Urology, University of Tsukuba Hospital, Tsukuba., Department of Urology, Yamaguchi University, Ube., Department of Urology, Kagoshima University, Kagoshima., Department of Urology, Hamamatsu University School of Medicine, Hamamatsu., Department of Urology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan., Department of Radiation Oncology & Image-applied Therapy, Kyoto University, Kyoto., Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan.