Incidences of visceral metastases from prostate cancer increase after progression of castration-resistant status.

Abstract

291 Background: Recent advances in castration-resistant prostate cancer (CRPC) therapy are remarkable, but we often experience a case of visceral metastases caused after CRPC progression and few data regarding the onset of visceral metastases after CRPC are available. In the present study, we retrospectively examined visceral metastases of prostate cancer (PCa) at our hospital. Methods: Between 2000 and 2014, 1038 patients with PCa were treated at our hospital. We collected and retroactively analyzed data from medical charts. Variables of interest included the ratio to cause CRPC and visceral metastases, the relationship between the number of therapeutic agents and visceral metastases, overall survival (OS), etc. Results: Patients were diagnosed with T1-2 (72.1%), T3-4 (24.5%), N1 (10.3%), M1 (11.7%), and M1c (1.8 %). There were 144 (19.8 %) patients with CRPC and 43 (33.1%) patients with visceral metastases after CRPC progression. Patients with CRPC showed significantly longer OS than patients without CRPC (p < 0.01). Of those with CRPC, patients with visceral metastases exhibited significantly shorter OS (p < 0.01). Patients with liver/adrenal gland metastases exhibited the shortest OS of all patients with CRPC (p = 0.02). At diagnosis, the sites of visceral metastases included lung (89.5%), liver (5.3%), and adrenal glands (5.3%). After CRPC progression, new visceral metastases were found in the lung (47.3%), liver (43.6%), and adrenal gland (9.1%). Liver and adrenal gland metastases significantly increased after CRPC progression (p < 0.01). Additionally, the rate of new visceral metastases significantly increased as the number of therapeutic agents increased (p < 0.0001). The median number of therapeutic agents being used was determined at the onset of visceral metastases to the lung (1), liver , and adrenal grand (5) (p < 0.001). Conclusions: Our findings confirmed that visceral metastases, especially liver and adrenal gland metastases, confer the worst survival. These metastases significantly increased as patients underwent powerful androgen deprivation therapy . Future prognostic improvements are expected through continued development of therapies for visceral metastases.