文章：

高容量去势敏感性前列腺癌中骨转移范围与肺转移的预后价值：一项回顾性研究

Prognostic Value of Bone Metastases by Extent of Disease and Lung Metastases in High-Volume Castration-Sensitive Prostate Cancer: A Retrospective Study

原文发布日期：13 October 2025

DOI: 10.3390/cancers17203306

类型: Article

开放获取: 是

英文摘要：

Backgrounds: High-volume (HV) metastatic castration-sensitive prostate cancer (mCSPC) is an aggressive disease. Despite this, we aimed to assess the metastatic patterns associated with a favorable prognosis in HV disease with bone metastasis (BM), including BM’s coexistence with lung metastasis (LM). Methods: We retrospectively analyzed 379 patients with synchronous mCSPC. They were categorized using the CHAARTED criteria as low-volume (LV) or HV with BM, classified based on extent of the disease from 1 to 4 (HV-EOD1–4) with or without LM. Multivariate Cox models for overall survival and castration-resistance-free survival assessed the prognostic values of HV-EOD1–4 compared with LV disease and the presence of LM. Site-specific radiographic progression at the time of castration-resistant prostate diagnosis was assessed in patients with BM and LM. Results: Multivariate analyses for overall survival showed no prognostic value of HV-EOD1 (hazard ratio [HR] 0.90; 95% confidence interval [CI] 0.43–1.85;p= 0.77), HV-EOD2 (HR 1.17; 95% CI 0.69–1.99;p= 0.57), and LM (HR 1.29; 95% CI 0.80–2.07;p= 0.29). In the analyses, HV-EOD ≤ 2 and LM did not influence castration resistance-free survival. LM showed a significantly lower incidence of radiographic progression to castration-resistant prostate cancer than BM (6.0% vs. 29.9%,p< 0.001). Conclusions: This study indicates the prognostic heterogeneity of HV disease considering BM and LM. These findings may aid in determining the treatment intensity for mCSPC.

摘要翻译： 

背景：高负荷（HV）转移性激素敏感性前列腺癌（mCSPC）是一种侵袭性疾病。尽管如此，本研究旨在评估伴有骨转移（BM）的HV疾病中与良好预后相关的转移模式，包括BM与肺转移（LM）共存的情况。方法：我们回顾性分析了379例同步性mCSPC患者。根据CHAARTED标准，将患者分为低负荷（LV）或伴有BM的HV疾病，并依据疾病范围（1至4级）分为HV-EOD1-4亚组，同时记录是否伴有LM。通过多变量Cox模型分析总生存期和无去势抵抗生存期，评估HV-EOD1-4与LV疾病相比以及LM存在的预后价值。在BM和LM患者中，评估了去势抵抗性前列腺癌诊断时特定部位的影像学进展。结果：总生存期的多变量分析显示，HV-EOD1（风险比[HR] 0.90；95%置信区间[CI] 0.43–1.85；p=0.77）、HV-EOD2（HR 1.17；95% CI 0.69–1.99；p=0.57）和LM（HR 1.29；95% CI 0.80–2.07；p=0.29）均无显著预后价值。在分析中，HV-EOD ≤ 2和LM对无去势抵抗生存期无影响。与BM相比，LM进展为去势抵抗性前列腺癌的影像学发生率显著较低（6.0% vs. 29.9%，p<0.001）。结论：本研究提示，考虑BM和LM的HV疾病存在预后异质性。这些发现可能有助于确定mCSPC的治疗强度。

原文链接：

Prognostic Value of Bone Metastases by Extent of Disease and Lung Metastases in High-Volume Castration-Sensitive Prostate Cancer: A Retrospective Study