The organ site where prostate cancer spreads directly impacts a patient’s chances of survival, scientists have revealed. Those whose cancer only metastasizes to the lymph nodes have the longest overall survival rate. Meanwhile, those whose cancer spreads to the liver have the lowest chance of survival.
Patients with lung and bone metastasis have a survival rate ‘somewhere in the middle’, according to a new study from Duke University Medical Center.
Lead study author Dr Susan Halabi said: ‘These results should help guide clinical decision-making for men with advanced prostate cancer.
‘They also suggest that prognostic subgroups should be considered for investigational therapies that are tested in clinical trials.’
The study was the largest ever analysis of the impact of prostate cancer metastasis sites on a patient’s survival rates.
Dr Halabi said: ‘Smaller studies have given doctors and patients indications that the site of metastasis in prostate cancer affects survival, but prevalence rates in organ sites were small, so it was difficult to provide good guidance.’
Duke scientists collaborated with colleagues from leading cancer research centers across the globe for the study.
They analyzed data relating to 8,736 men with metastatic prostate cancer from nine large, phase III clinical trials to examine their outcomes.
All of the patients underwent standard treatment, which entails the chemotherapy drug docetaxel.
They categorized the site of metastases into different groups: Lung, liver (without lung), lymph nodes only and bone without without lymph nodes and no other organ metastases.
Nearly 73 per cent of the patients had bone metastases.
Those patients had an overall median survival rate of just over 21 months.
Men who had lymph involvement were the smallest subset in the study – just 6.4 per cent.
However, those men had the longest median survival, of about 32 months.
Lastly, men with lung metastases represented 9.1 per cent of the study population – with a median survival time of 19 months.
Dr Halabi said: ‘With the large numbers we analyzed in our study, we were able to compare all of these different sites and provide information that could be helpful in conveying prognosis to patients.
‘This information could also be used to help guide treatment approaches using either hormonal therapy or chemotherapy.’
The scientist noted that more research must be conducted to understand how and why prostate cancer spreads to other organs.
The study was published in the Journal of Clinical Oncology.
