Pascale M et al. -Five-year survival in patients with localized prostate cancer (PCa) is nearly 100%, but metastatic disease is currently incurable. The current study evaluated the impact of the first metastatic progression on the outcome of PCa patients treated with curative intent. The current study confirmed that the first metastatic event confers a differential prognostic impact and may help identify patients at high risk of death.

Methods

• 913 cases of localized PCa were evaluated.
• All patients were treated with curative surgery (N = 382) or radiotherapy (N = 531) with or without adjuvant therapy. All metastases were radiologically documented.
• The prognostic impact of the first site of metastasis on metastasis-free survival (MFS) and PCa-specific survival (PCaSS) was determined.

Results

• 136 patients developed a metastatic hormone-sensitive PCa and had a median PCaSS of 50.4 months after first metastatic progression.
• Bone (N = 50) and LN or locoregional (N = 52) metastases occurred more frequently with a median PCaSS of 39.7 and 137 months respectively.
• Seven patients developed visceral metastasis only (5.1%; liver, lung, brain) and 27 (19.9%) concurrent metastases.