背景:前列腺癌是美国和欧洲男性中最常见的非皮肤恶性肿瘤。寡转移前列腺癌(omPC)没有一致的定义,这通常被认为是两个子组,同步(从头)和异时(寡复发),可能包括转移性疾病负担较低的患者。
目的:总结流行病学,疾病定义,死亡率/生存结果,以及同步患者在临床试验和现实环境中的治疗特征,异形,和混合亚型(即,同步和异时或未定义类型)omPC,以及低负担疾病状态。
方法:我们搜索了MEDLINE和Embase,以确定报告流行病学的出版物,疾病定义,临床结果,以及omPC的治疗特点。灰色文献来源(例如,ClinicalTrials.gov)进行了正在进行的试验。
结果:我们确定了105种出版物。疾病的定义因出版物和omPC亚型的不同而不同,在病变的数量和位置上,使用的成像类型,和寡转移疾病的类型。大多数研究将omPC定义为五个或更少的转移性病变。关于omPC的流行病学数据有限。在同步与异时omPC队列中,死亡率和总体生存率趋于更差。同步无进展生存期通常比异时omPC队列更长,但在更长的时间点更相似。正在进行的临床试验的摘要,调查各种本地,转移导向,还提供了omPC男性的全身疗法。
结论:寡转移疾病的定义取决于所使用的成像技术。omPC的流行病学数据很少。同步队列和异时队列之间的生存率不同,和异质的治疗模式导致不同的结果。正在进行的临床试验使用现代成像技术是等待和需要的。
结果:寡转移前列腺癌(omPC)的定义因使用的成像技术而异。不同的治疗模式导致不同的结果。缺乏可靠的omPC流行病学数据。
BACKGROUND: Prostate cancer is the most common noncutaneous malignancy among men in the USA and Europe. There is no consensus definition of
oligometastatic prostate cancer (omPC), which is often considered in two subgroups, synchronous (de novo) and metachronous (oligorecurrent), and may include patients with a low metastatic disease burden.
OBJECTIVE: To summarize the epidemiology, disease definitions, mortality/survival outcomes, and treatment characteristics in both clinical trial and real-world settings among patients with synchronous, metachronous, and mixed-subtype (ie, synchronous and metachronous or undefined type) omPC, as well as low burden disease states.
METHODS: We searched MEDLINE and Embase to identify publications reporting on epidemiology, disease definitions, clinical outcomes, and treatment characteristics of omPC. Gray literature sources (eg, ClinicalTrials.gov) were searched for ongoing trials.
RESULTS: We identified 105 publications. Disease definitions varied across publications and omPC subtypes on the number and location of lesions, type of imaging used, and type of
oligometastatic disease. Most studies defined omPC as five or fewer metastatic lesions. Data on the epidemiology of omPC were limited. Mortality rates and overall survival tended to be worse among synchronous versus metachronous omPC cohorts. Progression-free survival was generally longer among synchronous than among metachronous omPC cohorts but was more similar at longer time points. A summary of ongoing clinical trials investigating a variety of local, metastasis-directed, and systemic therapies in men with omPC is also provided.
CONCLUSIONS: Definitions of
oligometastatic disease depend on the imaging technique used. Epidemiologic data for omPC are scarce. Survival rates differ between synchronous and metachronous cohorts, and heterogeneous treatment patterns result in varied outcomes. Ongoing clinical trials using modern imaging techniques are awaited and needed.
RESULTS: Definitions of
oligometastatic prostate cancer (omPC) vary depending on the imaging technique used. Different treatment patterns lead to different outcomes. Robust omPC epidemiologic data are lacking.