Meta-analysis evaluating the impact of site of metastasis on overall survival in men with castration-resistant prostate cancer

Susan Halabi*, William Kevin Kelly, Hua Ma, Haojin Zhou, Nicole C. Solomon, Karim Fizazi, Catherine M. Tangen, Mark Rosenthal, Daniel P. Petrylak, Maha Hussain, Nicholas J. Vogelzang, Ian M. Thompson, Kim N. Chi, Johann De Bono, Andrew J. Armstrong, Mario A. Eisenberger, Abderrahim Fandi, Shaoyi Li, John C. Araujo, Christopher J. LogothetisDavid I. Quinn, Michael J. Morris, Celestia S. Higano, Ian F. Tannock, Eric J. Small

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

305 Scopus citations


Purpose Reports have suggested that metastatic site is an important predictor of overall survival (OS) in men with metastatic castration-resistant prostate cancer (mCRPC), but these were based on a limited number of patients.Weinvestigate the impact of site of metastases on OS of a substantial sample of men with mCRPC who received docetaxel chemotherapy in nine phase III trials. Patients and Methods Individual patient data from 8,820 men with mCRPC enrolled onto nine phase III trials were combined. Site of metastases was categorized as lymph node (LN) only, bone with or without LN (with no visceral metastases), any lung metastases (but no liver), and any liver metastases. Results Most patients had bone with or without LN metastases (72.8%), followed by visceral disease (20.8%) and LN-only disease (6.4%). Men with liver metastases had the worst median OS (13.5 months). Although menwith lungmetastases had bettermedian OS (19.4months) compared with menwith liver metastases, they had significantly worse median survival duration than men with nonvisceral bone metastases (21.3 months). Men with LN-only disease had a median OS of 31.6 months. The pooled hazard ratios for death in men with lung metastases compared with men with bone with or without LN metastases and in men with any liver metastases compared withmen with lung metastases were 1.14 (95% CI, 1.04 to 1.25; P = .007) and 1.52 (95% CI, 1.35 to 1.73; P , .0001), respectively. Conclusion Specific sites of metastases in men with mCRPC are associated with differential OS, with successive increased lethality for lung and liver metastases compared with bone and nonvisceral involvement. These data may help in treatment decisions, the design of future clinical trials, and understanding the variation in biology of different sites of metastases in men with mCRPC.A.

Original languageEnglish (US)
Pages (from-to)1652-1659
Number of pages8
JournalJournal of Clinical Oncology
Issue number14
StatePublished - May 10 2016

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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