A Novel Radiographic Pattern Related to Poor Prognosis in Patients with Prostate Cancer with Metastatic Spinal Cord...

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• Prostate cancer bone metastases can present a radiographic appearance similar to multiple myeloma.
• Identifying distinct metastatic patterns is crucial for understanding prognosis.

Purpose of the Study:

• To analyze the presence and prognostic significance of myeloma-like prostate cancer bone metastases.
• To investigate the relationship between this pattern and clinical, molecular, and morphological prognostic markers.

Main Methods:

• Retrospective analysis of 110 prostate cancer patients undergoing surgery for metastatic spinal cord compression (MSCC).
• Classification of spinal bone metastases as myeloma-like or non-myeloma-like based on MRI.
• Immunohistochemical analysis (Ki67, PSA, AR) and transcriptomic profiling (MetA, MetB, MetC).

Main Results:

• The myeloma-like metastatic pattern was associated with significantly shorter median survival (1.7 months vs. 13 months) after MSCC surgery (p < 0.001).
• This pattern independently predicted an increased risk of death post-surgery (aHR 2.4, p = 0.012).
• Patients with myeloma-like metastases had poorer postoperative neurological function and no association with transcriptomic subtypes, proliferation, AR, or PSA expression.

Conclusions:

• A myeloma-like metastatic pattern in prostate cancer signifies a distinct subtype associated with poor prognosis.
• This radiographic pattern is a critical indicator for survival and neurological outcomes following MSCC surgery.
• The study highlights a novel radiographic pattern of prostate cancer bone metastases linked to adverse patient outcomes.