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A Novel Radiographic Pattern Related to Poor Prognosis in Patients with Prostate Cancer with Metastatic Spinal Cord Compression
BACKGROUND: Prostate cancer spinal bone metastases can have a radiographic profile that mimics multiple myeloma. OBJECTIVE: To analyse the presence and prognostic value of myeloma-like prostate cancer bone metastases and its relation to known clinical, molecular, and morphological prognostic markers...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9895766/ https://www.ncbi.nlm.nih.gov/pubmed/36743403 http://dx.doi.org/10.1016/j.euros.2022.12.004 |
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author | Wänman, Johan Abul-Kasim, Kasim Semenas, Julius Thysell, Elin Bergh, Anders Wikström, Pernilla Crnalic, Sead |
author_facet | Wänman, Johan Abul-Kasim, Kasim Semenas, Julius Thysell, Elin Bergh, Anders Wikström, Pernilla Crnalic, Sead |
author_sort | Wänman, Johan |
collection | PubMed |
description | BACKGROUND: Prostate cancer spinal bone metastases can have a radiographic profile that mimics multiple myeloma. OBJECTIVE: To analyse the presence and prognostic value of myeloma-like prostate cancer bone metastases and its relation to known clinical, molecular, and morphological prognostic markers. DESIGN, SETTING, AND PARTICIPANTS: A cohort of 110 patients with prostate cancer who underwent surgery for metastatic spinal cord compression (MSCC) was analysed. Spinal bone metastases were classified as myeloma like (n = 20) or non–myeloma like (n = 90) based on magnetic resonance imaging prior to surgery. An immunohistochemical analysis of metastasis samples was performed to assess tumour cell proliferation (percentage of Ki67-positive cells) and the expression levels of prostate-specific antigen (PSA) and androgen receptor (AR). The metastasis subtypes MetA, MetB, and MetC were determined from transcriptomic profiling. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Survival curves were compared with the log-rank test. Univariate and multivariate Cox proportional hazard models were used to assess the effects of prognostic variables. Groups were compared using the Mann-Whitney U test for continuous variables and the chi-square test for categorical variables. RESULTS AND LIMITATIONS: Patients with the myeloma-like metastatic pattern had median survival after surgery for MSCC of 1.7 (range 0.1–33) mo, while the median survival period of those with the non–myeloma-like pattern was 13 (range 0–140) mo (p < 0.001). The myeloma-like appearance had an independent prognostic value for the risk of death after MSCC surgery (adjusted hazard ratio 2.4, p = 0.012). Postoperative neurological function was significantly reduced in the myeloma-like group. No association was found between the myeloma-like pattern and morphological markers of known relevance for this patient group: the transcriptomic subtypes MetA, MetB, and MetC; tumour cell proliferation; and AR and PSA expression. CONCLUSIONS: A myeloma-like metastatic pattern identifies an important subtype of metastatic prostate cancer associated with poor survival and neurological outcomes after surgery for MSCC. PATIENT SUMMARY: This study describes a novel radiographic pattern of prostate cancer bone metastases and its relation to poor patient prognosis. |
format | Online Article Text |
id | pubmed-9895766 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-98957662023-02-04 A Novel Radiographic Pattern Related to Poor Prognosis in Patients with Prostate Cancer with Metastatic Spinal Cord Compression Wänman, Johan Abul-Kasim, Kasim Semenas, Julius Thysell, Elin Bergh, Anders Wikström, Pernilla Crnalic, Sead Eur Urol Open Sci Prostate Cancer BACKGROUND: Prostate cancer spinal bone metastases can have a radiographic profile that mimics multiple myeloma. OBJECTIVE: To analyse the presence and prognostic value of myeloma-like prostate cancer bone metastases and its relation to known clinical, molecular, and morphological prognostic markers. DESIGN, SETTING, AND PARTICIPANTS: A cohort of 110 patients with prostate cancer who underwent surgery for metastatic spinal cord compression (MSCC) was analysed. Spinal bone metastases were classified as myeloma like (n = 20) or non–myeloma like (n = 90) based on magnetic resonance imaging prior to surgery. An immunohistochemical analysis of metastasis samples was performed to assess tumour cell proliferation (percentage of Ki67-positive cells) and the expression levels of prostate-specific antigen (PSA) and androgen receptor (AR). The metastasis subtypes MetA, MetB, and MetC were determined from transcriptomic profiling. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Survival curves were compared with the log-rank test. Univariate and multivariate Cox proportional hazard models were used to assess the effects of prognostic variables. Groups were compared using the Mann-Whitney U test for continuous variables and the chi-square test for categorical variables. RESULTS AND LIMITATIONS: Patients with the myeloma-like metastatic pattern had median survival after surgery for MSCC of 1.7 (range 0.1–33) mo, while the median survival period of those with the non–myeloma-like pattern was 13 (range 0–140) mo (p < 0.001). The myeloma-like appearance had an independent prognostic value for the risk of death after MSCC surgery (adjusted hazard ratio 2.4, p = 0.012). Postoperative neurological function was significantly reduced in the myeloma-like group. No association was found between the myeloma-like pattern and morphological markers of known relevance for this patient group: the transcriptomic subtypes MetA, MetB, and MetC; tumour cell proliferation; and AR and PSA expression. CONCLUSIONS: A myeloma-like metastatic pattern identifies an important subtype of metastatic prostate cancer associated with poor survival and neurological outcomes after surgery for MSCC. PATIENT SUMMARY: This study describes a novel radiographic pattern of prostate cancer bone metastases and its relation to poor patient prognosis. Elsevier 2022-12-26 /pmc/articles/PMC9895766/ /pubmed/36743403 http://dx.doi.org/10.1016/j.euros.2022.12.004 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Prostate Cancer Wänman, Johan Abul-Kasim, Kasim Semenas, Julius Thysell, Elin Bergh, Anders Wikström, Pernilla Crnalic, Sead A Novel Radiographic Pattern Related to Poor Prognosis in Patients with Prostate Cancer with Metastatic Spinal Cord Compression |
title | A Novel Radiographic Pattern Related to Poor Prognosis in Patients with Prostate Cancer with Metastatic Spinal Cord Compression |
title_full | A Novel Radiographic Pattern Related to Poor Prognosis in Patients with Prostate Cancer with Metastatic Spinal Cord Compression |
title_fullStr | A Novel Radiographic Pattern Related to Poor Prognosis in Patients with Prostate Cancer with Metastatic Spinal Cord Compression |
title_full_unstemmed | A Novel Radiographic Pattern Related to Poor Prognosis in Patients with Prostate Cancer with Metastatic Spinal Cord Compression |
title_short | A Novel Radiographic Pattern Related to Poor Prognosis in Patients with Prostate Cancer with Metastatic Spinal Cord Compression |
title_sort | novel radiographic pattern related to poor prognosis in patients with prostate cancer with metastatic spinal cord compression |
topic | Prostate Cancer |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9895766/ https://www.ncbi.nlm.nih.gov/pubmed/36743403 http://dx.doi.org/10.1016/j.euros.2022.12.004 |
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