Abstract：
BACKGROUND: Metachronous metastatic prostate cancer (mmPCa) patients harbor different characteristics and outcomes, relative to DeNovo metastatic PCa patients. Onset of metastatic disease might be influenced by primary PCa characteristics such as Gleason score (GS) or cancer stage, as well as overall survival (OS) by timing of metastatic onset.
METHODS: We relied on an institutional tertiary-care database to identify mmPCa patients. Kaplan Meier and Cox Regression models tested for onset of metastases and OS, stratified according to GS, pathological stage and time to mmPCa.
RESULTS: Of 341 mmPCa patients, 8% harbored GS6 versus 41% versus 51% GS7 and GS8-10. Median time to onset of metastatic disease was 79 versus 54 versus 41 months for GS6 versus GS7 versus GS8-10 (P = .01). Moreover, median time to onset of metastases was 64 versus 44 months for pT1-2 versus pT3-4 mmPCa patients undergoing radical prostatectomy (P = .027). In multivariable Cox regression models, higher GS and pT-stage was associated with earlier onset of metastases. Additionally, significant OS differences could be observed for time interval of < 24 versus 24-60 versus 60-120 versus ≥ 120 months between primary PCa diagnosis and onset of mmPCa. Specifically, median OS was 56 versus 69 versus 97 months versus not reached (P < .01) for these categories. In multivariable Cox regression, shorter time to metastatic onset was associated with shorter OS.
CONCLUSIONS: Timing of mmPCa is strongly influenced by grading and pT-stage in real-life setting. OS benefits can be observed with longer time interval between primary PCa diagnosis and onset of mmPCa.
METHODS: We relied on an institutional tertiary-care database to identify mmPCa patients. Kaplan Meier and Cox Regression models tested for onset of metastases and OS, stratified according to GS, pathological stage and time to mmPCa.
RESULTS: Of 341 mmPCa patients, 8% harbored GS6 versus 41% versus 51% GS7 and GS8-10. Median time to onset of metastatic disease was 79 versus 54 versus 41 months for GS6 versus GS7 versus GS8-10 (P = .01). Moreover, median time to onset of metastases was 64 versus 44 months for pT1-2 versus pT3-4 mmPCa patients undergoing radical prostatectomy (P = .027). In multivariable Cox regression models, higher GS and pT-stage was associated with earlier onset of metastases. Additionally, significant OS differences could be observed for time interval of < 24 versus 24-60 versus 60-120 versus ≥ 120 months between primary PCa diagnosis and onset of mmPCa. Specifically, median OS was 56 versus 69 versus 97 months versus not reached (P < .01) for these categories. In multivariable Cox regression, shorter time to metastatic onset was associated with shorter OS.
CONCLUSIONS: Timing of mmPCa is strongly influenced by grading and pT-stage in real-life setting. OS benefits can be observed with longer time interval between primary PCa diagnosis and onset of mmPCa.
摘要：
背景：异时转移性前列腺癌（mmPCa）患者具有不同的特征和结果，相对于DeNovo转移性PCa患者。转移性疾病的发病可能受到原发性PCa特征的影响，如Gleason评分(GS)或癌症分期。以及转移发作时间的总生存期（OS）。
方法：我们依靠机构三级护理数据库来识别mmPCa患者。KaplanMeier和Cox回归模型测试了转移和OS的发作，根据GS分层，MPCa的病理分期和时间。
结果：在341名mmPCa患者中，8%的人持有GS6，而41%的人持有GS7和GS8-10的比例为51%。GS6与GS7与GS8-10的转移性疾病发病的中位时间分别为79个月和54个月和41个月（P=0.01）。此外，接受根治性前列腺切除术的pT1-2和pT3-4mmPCa患者发生转移的中位时间分别为64个月和44个月(P=.027).在多变量Cox回归模型中，较高的GS和pT分期与较早发生转移相关.此外,在原发性PCa诊断和mmPCa发病之间的时间间隔<24个月和24-60个月和60-120个月和≥120个月时,可以观察到显著的OS差异.具体来说,这些类别的中位OS分别为56个月和69个月和97个月,与未达到相比(P<.01).在多变量Cox回归中，转移发作时间较短与OS较短相关.
结论：在现实生活中，mmPCa的时间受到分级和pT分期的强烈影响。在原发性PCa诊断和mmPCa发作之间的时间间隔较长时，可以观察到OS益处。
方法：我们依靠机构三级护理数据库来识别mmPCa患者。KaplanMeier和Cox回归模型测试了转移和OS的发作，根据GS分层，MPCa的病理分期和时间。
结果：在341名mmPCa患者中，8%的人持有GS6，而41%的人持有GS7和GS8-10的比例为51%。GS6与GS7与GS8-10的转移性疾病发病的中位时间分别为79个月和54个月和41个月（P=0.01）。此外，接受根治性前列腺切除术的pT1-2和pT3-4mmPCa患者发生转移的中位时间分别为64个月和44个月(P=.027).在多变量Cox回归模型中，较高的GS和pT分期与较早发生转移相关.此外,在原发性PCa诊断和mmPCa发病之间的时间间隔<24个月和24-60个月和60-120个月和≥120个月时,可以观察到显著的OS差异.具体来说,这些类别的中位OS分别为56个月和69个月和97个月,与未达到相比(P<.01).在多变量Cox回归中，转移发作时间较短与OS较短相关.
结论：在现实生活中，mmPCa的时间受到分级和pT分期的强烈影响。在原发性PCa诊断和mmPCa发作之间的时间间隔较长时，可以观察到OS益处。
