In possibly the largest analysis of its kind, researchers at the Duke Cancer Institute have found that where prostate cancer spreads has a direct impact on patient survival. Patients with lymph-only metastasis have the longest overall survival, while those with liver involvement fared the worst. Lung and bone metastasis fell in the middle. Researchers studied data from nine phase III clinical trials involving the outcomes of 8,736 men with metastatic prostate cancer. All patients had undergone standard treatment with the chemotherapy drug docetaxel.
Researchers divided participants into four groups: lung, liver (without lung), lymph nodes only, bone with or without lymph nodes and no other organ metastases. Almost 73% of the men had bone metastases, 8.6% of the men had liver metastases, 9.1% of the men had lung metastases and 6.4% had metastases to the lymph nodes only. The team also found that the survival varied greatly depending on what site their prostate cancer had spread to.
“Smaller studies had given doctors and patients indications that the site of metastasis in prostate cancer affects survival, but prevalence rates in organ sites were small, so it was difficult to provide good guidance. With the large numbers we analyzed in our study, we were able to compare all of these different sites and provide information that could be helpful in conveying prognosis to patients. This information could also be used to help guide treatment approaches using either hormonal therapy or chemotherapy.”
Susan Halabi, Ph.D., professor of biostatistics at the Duke Cancer Institute
Men whose cancer had spread to the lymph nodes only had the longest median survival, at 32 months, while those whose cancer had spread to the liver had the shortest median survival, at 14 months. Bone metastasis was linked to a median survival of just over 21 months, while men whose prostate cancer had spread to the lung had a median survival of 19 months. Dr. Halabi further added that more research is needed to understand how and why prostate cancer spreads to different organs.
The study was published in the Journal of Clinical Oncology.