Traditional Prostate Cancer Risk Assessment Scales Do Not Predict Outcomes from Brain Metastases: A Population-Based...

Area of Science:

• Oncology
• Neurology
• Public Health

Background:

• Brain metastases are a rare but serious complication of prostate cancer.
• Limited understanding exists regarding the progression, treatment, and outcomes of prostate cancer with brain metastasis.

Purpose of the Study:

• To investigate prognostic factors influencing overall survival (OS) in patients with prostate cancer metastatic to the brain.
• To develop a prognostic nomogram to aid in the management of these patients.

Main Methods:

• Retrospective analysis of 461 patients with prostate cancer brain metastases using the Surveillance, Epidemiology, and End Results (SEER) database.
• Cox regression (univariate and multivariable) analyses were performed.
• A prognostic nomogram was developed based on the identified factors.

Main Results:

• The median overall survival (OS) was 15 months.
• Hispanic patients showed significantly increased OS (17 months).
• Larger tumor size (>3 cm) and liver metastases were associated with significantly reduced OS (19 months and 3.5 months, respectively).
• Treatment with chemotherapy/systemic therapy (19 months) or radiation and chemotherapy (25 months) improved survival.
• The developed nomogram achieved a C-index of 0.641.

Conclusions:

• Prognosis for prostate cancer with brain metastases is significantly impacted by race, tumor size, additional metastatic sites, and treatment modalities.
• Traditional prostate cancer grading systems (Gleason, ISUP) did not correlate with mortality in this cohort.
• The developed prognostic nomogram offers a tool for individualized patient management and treatment guidance.