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

Research Paper

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

Yadong Guo1†, Shiyu Mao 1†, Aihong Zhang2†, Ruiliang Wang1, Ziwei Zhang1, Junfeng Zhang1, Longsheng Wang1, Wentao Zhang3, Yuan Wu3, Lin Ye1, Bin Yang1✉, Xudong Yao1✉

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
† These authors contributed equally to this study.

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, metastases, prognosis, age, surveillance, SEER data

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How to cite this article:
Guo Y, Mao S, Zhang A, Wang R, Zhang Z, Zhang J, Wang L, Zhang W, Wu Y, Ye L, Yang B, Yao X. Prognostic Significance of Young Age and Non-Bone Metastasis at Diagnosis in Patients with Metastatic Prostate Cancer: a SEER Population-Based Data Analysis. J Cancer 2019; 10(3):556-567. doi:10.7150/jca.29481. Available from http://www.jcancer.org/v10p0556.htm