Traditional Prostate Cancer Risk Assessment Scales Do Not Predict Outcomes from Brain Metastases: A Population-Based Predictive Nomogram.

Autor: Ladner LR; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA., Adhikari S; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA.; Department of Neurosurgery, Carilion Clinic, 1906 Belleview Avenue, Roanoke, VA 24014, USA.; School of Neuroscience, Virginia Polytechnic Institute and State University, 210 Drillfield Drive, Blacksburg, VA 24061, USA., Bhutada AS; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA.; Department of Neurosurgery, Carilion Clinic, 1906 Belleview Avenue, Roanoke, VA 24014, USA.; School of Neuroscience, Virginia Polytechnic Institute and State University, 210 Drillfield Drive, Blacksburg, VA 24061, USA., Cuoco JA; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA.; Department of Neurosurgery, Carilion Clinic, 1906 Belleview Avenue, Roanoke, VA 24014, USA.; School of Neuroscience, Virginia Polytechnic Institute and State University, 210 Drillfield Drive, Blacksburg, VA 24061, USA., Patel VM; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA.; Department of Neurosurgery, Carilion Clinic, 1906 Belleview Avenue, Roanoke, VA 24014, USA.; School of Neuroscience, Virginia Polytechnic Institute and State University, 210 Drillfield Drive, Blacksburg, VA 24061, USA., Entwistle JJ; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA.; Department of Neurosurgery, Carilion Clinic, 1906 Belleview Avenue, Roanoke, VA 24014, USA.; School of Neuroscience, Virginia Polytechnic Institute and State University, 210 Drillfield Drive, Blacksburg, VA 24061, USA., Rogers CM; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA.; Department of Neurosurgery, Carilion Clinic, 1906 Belleview Avenue, Roanoke, VA 24014, USA.; School of Neuroscience, Virginia Polytechnic Institute and State University, 210 Drillfield Drive, Blacksburg, VA 24061, USA., Marvin EA; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA.; Department of Neurosurgery, Carilion Clinic, 1906 Belleview Avenue, Roanoke, VA 24014, USA.; School of Neuroscience, Virginia Polytechnic Institute and State University, 210 Drillfield Drive, Blacksburg, VA 24061, USA.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2024 Aug 30; Vol. 16 (17). Date of Electronic Publication: 2024 Aug 30.
DOI: 10.3390/cancers16173029
Abstrakt: Brain metastases are an uncommon yet life-limiting manifestation of prostate cancer. However, there is limited insight into the natural progression, therapeutics, and patient outcomes for prostate cancer once metastasized to the brain. This is a retrospective study of 461 patients with metastatic prostate cancer to the brain with a primary outcome of median overall survival (OS). The Surveillance, Epidemiology, and End Results (SEER) database was examined using Cox regression univariate and multivariable analyses, and a corresponding nomogram was developed. The median overall survival was 15 months. In the multivariable analysis, Hispanic patients had significantly increased OS (median OS 17 months, p = 0.005). Patients with tumor sizes greater than three centimeters exhibited significantly reduced OS (median OS 19 months, p = 0.014). Patients with additional metastases to the liver exhibited significantly reduced OS (median OS 3.5 months, p < 0.001). Increased survival was demonstrated in patients treated with chemotherapy or systemic treatment (median OS 19 months, p = 0.039), in addition to radiation and chemotherapy (median OS 25 months, p = 0.002). The nomogram had a C-index of 0.641. For patients with prostate metastases to the brain, median OS is influenced by race, tumor size, presence of additional metastases, and treatment. The lack of an association between traditional prostate cancer prognosis metrics, including Gleason and ISUP grading, and mortality highlights the need for individualized, metastasis-specific prognosis metrics. This prognostic nomogram for prostate metastases to the brain can be used to guide the management of affected patients.
Databáze: MEDLINE
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