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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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.
