Abstract
Background
Prostate cancer (PC) rarely metastasizes to the central nervous system (CNS). In this
retrospective single-institution study at a tertiary cancer center, we aimed to evaluate
the clinical and genetic characteristics of advanced PC patients with CNS metastases.
Patients and Methods
Between January 2010 and March 2020, 12 out of 579 patients with extracranial metastatic
PC were identified to have CNS metastases based on imaging, including six patients
with brain metastases (BMs), five patients with dural metastases, and one unknown.
These patients were followed up through March 2022. Clinical data were compared to
the overall cohort of patients evaluated at our cancer center during that decade.
Genetics information was also analyzed for the patients with available data via cell-free
DNA (cfDNA) blood samples.
Results
Median time from development of extracranial metastatic disease to development of
CNS metastases was 5.5 years (95% CI, 1.8-7.0). Median overall survival (mOS) from
diagnosis of CNS metastases was 6.1 months (95% CI, 5.8-8.2). Notably, there was no
significant difference in mOS after development of extracranial metastases in patients
with CNS metastases (6.4 years; 95% CI, 4.6-7.9) compared to the patients without
known CNS metastases (5.2 years; 95% CI, 4.6-5.7) (P = .91). For the cohort with CNS metastases, nine patients had germline testing and
seven patients had somatic testing via cfDNA.
Conclusion
PC patients with CNS metastases did not often die from a neurological cause. With
advancing therapies, the overall prognosis of metastatic PC continues to improve,
and CNS metastases will become more common.
Keywords
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References
Key Statistics for Prostate Cancer. American Cancer Society. 2022.
- Brain metastasis from prostate carcinoma: the M D Anderson Cancer Center experience.Cancer. 2003; 98: 363-368
- Brain metastases from prostate cancer: an 11-year analysis in the MRI era with emphasis on imaging characteristics, incidence, and prognosis.Jneuroimaging: jAmSoc Neuroimaging. 2014; 24: 161-166
- Prognostic significance of young age and non-bone metastasis at diagnosis in patients with etastatic Prostate Cancer: a SEER population-based data analysis.J Cancer. 2019; 10: 556-567
- Metastatic patterns of prostate cancer: an autopsy study of 1589 patients.Hum pathol. 2000; 31: 578-583
- Recent advances in the management of Metastatic Prostate Cancer.JCO oncol pract. 2022; 18: 45-55
- Prostate cancer brain metastases: a single-institution experience.World Neurosurg. 2020; 138: e445-ee49
- Prostate cancer central nervous system metastasis in a contemporary cohort.Clin Genitourin Cancer. 2021; 19: 217-222
- Stereotactic radiosurgery for patients with multiple brain metastases (JLGK0901): a multi-institutional prospective observational study.Lancet Oncol. 2014; 15: 387-395
- Distribution of brain metastases.Arch Neurol. 1988; 45: 741-744
- Brain metastases in patients with pelvic or abdominal malignancy do not prevail in the posterior fossa: a retrospective study.J Neurol. 2009; 256: 1485-1487
- PSMA theranostics: review of the current status of PSMA-targeted imaging and radioligand therapy.Cancers (Basel). 2020; : 12
Patel M, Wijetunga NA, Lobaugh S, Zhang Z, McBride SM, Chan TA-t. Clinical, genetic, and pathologic determinants of prostate cancer brain metastasis: American Society of Clinical Oncology; 2020.
- Alterations in homologous recombination repair genes in prostate cancer brain metastases.Nat Commun. 2022; 13: 2400
- PROMISE: a real-world clinical-genomic database to address knowledge gaps in prostate cancer.Prostate Cancer Prostatic Dis. 2021;
- Tackling diversity in prostate cancer clinical trials: a report from the diversity working group of the IRONMAN registry.JCO Glob Oncol. 2021; 7: 495-505
Article info
Publication history
Published online: October 20, 2022
Accepted:
October 15,
2022
Received in revised form:
October 11,
2022
Received:
September 1,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.