Is computed tomography a necessary part of a metastatic evaluation for castration-resistant prostate cancer? Results from the Shared Equal Access Regional Cancer Hospital Database
| Autor: | Hanyok, BT, Howard, LE, Amling, CL, Aronson, WJ, Cooperberg, MR, Kane, CJ, Terris, MK, Posadas, EM, Freedland, SJ |
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| Rok vydání: | 2016 |
| Předmět: |
Male
prevalence Oncology and Carcinogenesis Bone Neoplasms Soft Tissue Neoplasms Castration-Resistant Risk Assessment Disease-Free Survival Databases Predictive Value of Tests 80 and over Humans prostate-specific antigen Neoplasm Invasiveness Oncology & Carcinogenesis Tomography Factual Neoplasm Staging Retrospective Studies Aged castration-resistant prostatic neoplasms Prostatic Neoplasms soft-tissue neoplasms Prognosis Survival Analysis X-Ray Computed Logistic Models computed X-ray tomography metastasis Public Health and Health Services Lymph Nodes |
| Zdroj: | Cancer, vol 122, iss 2 Hanyok, BT; Howard, LE; Amling, CL; Aronson, WJ; Cooperberg, MR; Kane, CJ; et al.(2015). Is computed tomography a necessary part of a metastatic evaluation for castration-resistant prostate cancer? Results from the Shared Equal Access Regional Cancer Hospital Database. Cancer. doi: 10.1002/cncr.29748. UCSF: Retrieved from: http://www.escholarship.org/uc/item/583926gg Hanyok, BT; Howard, LE; Amling, CL; Aronson, WJ; Cooperberg, MR; Kane, CJ; et al.(2016). Is computed tomography a necessary part of a metastatic evaluation for castration-resistant prostate cancer? Results from the Shared Equal Access Regional Cancer Hospital Database. Cancer, 122(2), 222-229. doi: 10.1002/cncr.29748. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/1928v8r2 |
| DOI: | 10.1002/cncr.29748. |
| Popis: | BackgroundMetastatic lesions in prostate cancer beyond the bone have prognostic importance and affect clinical therapeutic decisions. Few data exist regarding the prevalence of soft-tissue metastases at the initial diagnosis of metastatic castration-resistant prostate cancer (mCRPC).MethodsThis study analyzed 232 men with nonmetastatic (M0) castration-resistant prostate cancer (CRPC) who developed metastases detected by a bone scan or computed tomography (CT). All bone scans and CT scans within the 30 days before or after the mCRPC diagnosis were reviewed. The rate of soft-tissue metastases among those undergoing CT was determined. Then, predictors of soft-tissue metastases and visceral and lymph node metastases were identified.ResultsCompared with men undergoing CT (n = 118), men undergoing only bone scans (n = 114) were more likely to have received primary treatment (P = .048), were older (P = .013), and less recently developed metastases (P = .018). Among those undergoing CT, 52 (44%) had soft-tissue metastases, including 20 visceral metastases (17%) and 41 lymph node metastases (35%), whereas 30% had no bone involvement. In a univariable analysis, only prostate-specific antigen (PSA) predicted soft-tissue metastases (odds ratio [OR], 1.27; P = .047), and no statistically significant predictors of visceral metastases were found. A higher PSA level was associated with an increased risk of lymph node metastases (OR, 1.38; P = .014), whereas receiving primary treatment was associated with decreased risk (OR, 0.36; P = .015).ConclusionsThe data suggest that there is a relatively high rate of soft-tissue metastasis (44%) among CRPC patients undergoing CT at the initial diagnosis of metastases, including some men with no bone involvement. Therefore, forgoing CT during a metastatic evaluation may lead to an underdiagnosis of soft-tissue metastases and an underdiagnosis of metastases in general. Cancer 2015. © 2015 American Cancer Society. Cancer 2016;122:222-229. © 2015 American Cancer Society. |
| Databáze: | OpenAIRE |
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