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J Cancer. 2019 Jan 1;10(3):556-567. doi: 10.7150/jca.29481. eCollection 2019.

Prognostic Significance of Young Age and Non-Bone Metastasis at Diagnosis in Patients with Metastatic Prostate Cancer: a SEER Population-Based Data Analysis.

Author information

1
Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, P.R. China.
2
Department of Medical Statistics, Tongji University School of Medicine, Shanghai, 200092, P.R. China.
3
Department of Urology, Shanghai Tenth People's Hospital, Anhui Medical University, Hefei 230032, P.R. China.

Abstract

Objective: This study compared the clinicopathological features and survival of metastatic prostate cancer (mPCa) after stratification by age and non-bone-related metastasis to identify prognostic factors. Methods: Patients with mPCa between 2010 and 2015 were identified from the Surveillance, Epidemiology and End Results database and analyzed. The overall survival (OS) rate was assessed using the Kaplan-Meier curve and log-rank test as well as multivariate Cox regression analysis. Results: Among the 10147 patients with mPCa, 5378 were classified as young (≤70 years), 3140 were classified as middle-aged (70-82 years), and 1629 were classified as elderly (> 82 years). The younger patients with a single site metastasis with non-regional lymph nodes (NRLN) had a better prognosis than those with bone metastasis [hazard ratio (HR), 0.59, 95% confidence interval (CI), 0.47-0.73, P < 0.001], whereas patients with liver metastasis had the worst OS rate (P = 0.001). Moreover, patients in the middle-aged group with NRLN or lung metastasis had a better prognosis than those with bone metastasis (P < 0.05). The OS rate of patient with bone + liver and bone + brain metastasis was poorer (P < 0.001) than those with bone + NRLN metastasis in the younger patients (P < 0.05). The elder patients with bone + lung metastasis had the worst OS (HR, 1.54; 95% CI, 1.25-1.90, P < 0.001), although the death risk of patients with bone + brain and bone + NRLN metastasis not significantly different (P > 0.05). However, the OS of the patients with bone + liver metastasis remained the worst (P < 0.001). Conclusions: Prostate cancer patients with lung metastasis or younger patients (≤70 years old) with bone + lung metastases had better OS than patients with other types of metastasis or old age.

KEYWORDS:

Metastatic prostate cancer; SEER data; age; metastases; prognosis; surveillance

Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

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