Pretreatment visceral metastases in castration resistant metastatic prostate cancer: role in prediction versus actual site of disease progression
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Published:2022-07-14
Issue:1
Volume:22
Page:
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ISSN:1470-7330
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Container-title:Cancer Imaging
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language:en
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Short-container-title:Cancer Imaging
Author:
Ruchalski KathleenORCID, Kim Hyun J., Douek Michael, Raman Steven, Patel Maitraya, Sai Victor, Gutierrez Antonio, Levine Benjamin, Fischer Cheryce, Allen-Auerbach Martin, Gupta Pawan, Coy Heidi, Villegas Bianca, Brown Matthew, Goldin Jonathan
Abstract
Abstract
Background
To evaluate the anatomic site(s) of initial disease progression in patients with castration resistant metastatic prostate cancer (mCRPC) in the presence or absence of pre-treatment visceral metastases while on systemic therapy.
Methods
This is a retrospective cohort study of mCRPC patients who have baseline and at least one follow up bone scan and CT chest, abdomen and pelvis (CAP). Disease progression was determined by RECIST and/or ≥ 30% increase in automated bone scan lesion area score. Kaplan–Meier plot was used to estimate the median progression free survival and log-rank tests were used to compare anatomic sites.
Results
Of 203 patients, 61 (30%) had pre-treatment visceral metastases. Patients with baseline visceral disease were 1.5 times more likely to develop disease progression (HR = 1.53; 95% CI, 1.03–2.26). Disease progression was a result of worsening bone scan disease (42% (16/38)) versus visceral (32% (12/38)) or lymph node disease (3% (1/38)) by CT or a combination thereof (23% (9/38)). Median time to progression (TTP) did not differ by anatomic location of initial progression (p = 0.86). Development of new lesions occurred in 50% of those visceral patients with soft tissue only progression and was associated with a significantly longer TTP (3.1 months (2.8–4.3 months) than those with worsening of pre-existing lesions (1.8 months (1.6–2.7 months); p = 0.04.
Conclusions
Patients with pre-treatment visceral metastases in mCRPC are more likely to experience disease progression of bone disease with the initial anatomic site of progression similar to those without baseline visceral involvement.
Publisher
Springer Science and Business Media LLC
Subject
Radiology, Nuclear Medicine and imaging,Oncology,General Medicine,Radiological and Ultrasound Technology
Reference31 articles.
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