Overall Survival of Metastatic Prostate Cancer Patients According to Location of Visceral Metastatic Sites

The prognostic significance of specific visceral sites of metastases in prostate cancer patients is not well established, as well as the interaction between visceral and nonvisceral metastatic sites. Prostate cancer patients with visceral metastases limited to lung have the best prognosis, especially if associated with concomitant nonvisceral lymph node metastases. Patients with visceral liver and/or brain metastases have invariably dismal survival, regardless the type of concomitant nonvisceral metastases. Introduction: It is unknown whether specific locations of visceral metastatic sites affect overall survival (OS) of metastatic prostate cancer (mPCa) patients. We tested the association between specific locations of visceral metastatic sites and OS in mPCa patients. Materials and Methods: Within Surveillance, Epidemiology and End Results database (2010-2016), survival analyses relied on specific locations of visceral metastases: lung only vs. liver only vs. brain only vs. >2 visceral sites. Kaplan-Meier plots and Cox regression models were fitted. Results: Of 1827 patients, 1044 (57%) harbored lung only visceral metastases vs. 457 (25%) liver only vs. 131 (7%) brain only vs. 195 (11%) >2 visceral sites. Median OS was 22 months in all patients vs. 33 months in lung only vs. 15 months in liver only vs. 16 months in brain only vs. 15 months in patients with >2 visceral sites. Highest OS was recorded in lung only visceral metastases patients, especially when concomitant nonvisceral metastases were located in lymph nodes only (median OS 57 months) vs. bone only (26 months) vs. lymph nodes and bone (28 months). Liver only, brain only or >2 visceral sites exhibited poor OS, regardless of concomitant nonvisceral metastases type (median OS from 13 to 19 months). Conclusion: In mPCa patients, lung only visceral metastases, especially when associated with lymph node only nonvisceral metastases, portend the best prognosis. Conversely, visceral metastatic sites other than lung portend poor prognosis, regardless of concomitant nonvisceral metastases type.