Regional location of lymph node metastases predicts survival in patients with de novo metastatic prostate cancer  

作　　者：Zhi-Peng Wang Jun-Ru Chen Jin-Ge Zhao Sha Zhu Xing-Ming Zhang Jia-Yu Liang Ben He Yu-Chao Ni Guang-Xi Sun Peng-Fei Shen Hao Zeng 

机构地区：[1]Department of Urology,Institute of Urology,West China Hospital,Sichuan University,Chengdu 610041,China [2]Department of Urology,The Third People’s Hospital of Chengdu,Chengdu 610031,China

出　　处：《Asian Journal of Andrology》2023年第4期462-467,共6页亚洲男性学杂志（英文版）

基　　金：supported by the National Natural Science Foundation of China(No.82172785,82103097,81974398,81902577,and 81872107);the Science and Technology Support Program of Sichuan Province(2021YFS0119);the 1.3.5 Project for Disciplines of Excellence,West China Hospital,Sichuan University(No.0040205301E21)。

摘　　要：To report the regional locations of metastases and to estimate the prognostic value of the pattern of regional metastases inmen with metastatic hormone-sensitive prostate cancer (mHSPC), we retrospectively analyzed 870 mHSPC patients betweenNovember 28, 2009, and February 4, 2021, from West China Hospital in Chengdu, China. The patients were initially classifiedinto 5 subgroups according to metastatic patterns as follows: simple bone metastases (G1), concomitant bone and regional lymphnode (LN) metastases (G2), concomitant bone and nonregional LN (NRLN) metastases (G3), lung metastases (G4), and livermetastases (G5). In addition, patients in the G3 group were subclassified as G3a and G3b based on the LN metastatic plane(below or above the diaphragm, respectively). The associations of different metastatic patterns with castration-resistant prostatecancer-free survival (CFS) and overall survival (OS) were analyzed by univariate and multivariate analyses. The results showedthat patients in G1 and G2 had relatively favorable clinical outcomes, patients in G3a and G4 had intermediate prognoses, andpatients in G3b and G5 had the worst survival outcomes. We observed that patients in G3b had outcomes comparable to those inG5 but had a significantly worse prognosis than patients in G3a (median CFS: 8.2 months vs 14.3 months, P = 0.015;medianOS: 38.1 months vs 45.8 months, P = 0.038). In conclusion, metastatic site can predict the prognosis of patients with mHSPC,and the presence of concomitant bone and NRLN metastases is a valuable prognostic factor. Furthermore, our findings indicatethat the farther the NRLNs are located, the more aggressive the disease is.

关 键 词：lymph node metastases metastatic hormone-sensitive prostate cancer metastatic pattern metastatic site nonregional lymph node metastases STAGING 

分 类 号：R737.25[医药卫生—肿瘤]