A Surveillance, Epidemiology and End Results database analysis of the prognostic value of organ-specific metastases in patients with advanced prostatic adenocarcinoma

Prostate cancer (PCa) survival markedly decreases with the occurrence of distant metastasis, and treatment decisions can be influenced by metastasis site, and affect patient survival outcomes. The aim of the present study was to evaluate the potential prognostic value of metastasis to specific sites and the prognostic value of prostatectomy in patients with only bone metastasis, and to determine potential risk factors for bone metastasis in prostatic adenocarcinoma using large scale clinical data. The Surveillance, Epidemiology and End Results (SEER) database (2010-2013) was queried via the SEER*Stat (version 8.3.4) program. A total of 210,730 prostatic adenocarcinoma patients were identified from the SEER database between January 2010 and December 2013. Univariate and multivariate Cox regression analysis and Kaplan-Meier curves were used for survival comparisons with corresponding 95% confidence intervals. Patients with PCa with only liver metastatic lesions had worse overall and cancer-specific survival rates compared with those patients with only bone or lung metastasis. Multivariate Cox regression analysis revealed that age <50 years, married status, T1 and T3 tumor stage according to Tumor-Node-Metastasis (TNM) staging system from the 7th AJCC cancer staging manual, and prostatectomy were associated with better overall survival and cancer-specific survival in patients with only bone metastasis. Binary logistic regression analysis revealed that unmarried status, African descent and undifferentiated histological grade were risk factors for PCa bone metastasis. Prostatic adenocarcinoma patients with only liver metastasis had worse prognostic outcomes compared with patients with other distant organ metastases. Prostatectomy improved the 3-year survival rate in stage IV PCa patients and stage IV PCa patients with only bone metastasis. These findings were based on large-scale clinical data and can provide novel perspectives for the treatment of patients with advanced prostate adenocarcinoma.