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Survival Differs With Metastatic Site in Castration-Resistant Prostate Cancer

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Key Points

  • In men with castration-resistant prostate cancer, the median overall survival was 31.6 months in lymph node–only disease, 21.3 months for nonvisceral bone metastases, 19.4 months for lung metastases, and 13.5 months for liver metastases.
  • The survival difference was significant for lung vs bone metastases and for liver vs lung metastases.

Overall survival differed according to the site of metastases in men with castration-resistant prostate cancer, according to a meta-analysis reported in the Journal of Clinical Oncology by Halabi et al.

Study Details

The study involved data from 8,820 men who received docetaxel chemotherapy in nine phase III trials. The site of metastases was categorized as lymph node only, bone with or without lymph node (with no visceral metastases), lung metastases (but no liver), and any liver metastases.

Survival by Site

The most common site was bone with or without lymph node metastases (72.8%; 42.9% bone only), followed by visceral disease (20.8%; 9.1% lung and 8.4% liver, with 173 cases of both lung and liver classified as liver) and lymph node–only disease (6.4%). Median overall survival was 31.6 months in lymph node–only disease, followed by 21.3 months in men with nonvisceral bone metastases, 19.4 months in those with lung metastases, and 13.5 months for those with liver metastases; men with any visceral disease had a median overall survival of 16.3 months. The pooled hazard ratio for death in men with lung metastases vs those with bone with or without lymph node metastases was 1.14 (P = .007) and in men with any liver metastases vs those with lung metastases was 1.52 (P < .0001).

The investigators concluded: “Specific sites of metastases in men with [metastatic castration-resistant prostate cancer] are associated with differential [overall survival], with successive increased lethality for lung and liver metastases compared with bone and nonvisceral involvement. These data may help in treatment decisions, the design of future clinical trials, and understanding the variation in biology of different sites of metastases in men with [metastatic castration-resistant prostate cancer].”

The study was supported by the National Institutes of Health and a congressionally directed medical research programs U.S. Army medical research grant.

Susan Halabi, PhD, of Duke University Medical Center, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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