Where to next? The main sites of metastasis in prostate cancer

The authors aimed to investigate the main sites of metastasis in metastatic prostate cancer.

While most new prostate cancer diagnoses involve localized disease (cancer that is still confined to the prostate), up to 17% of patients may experience metastatic disease (spread of the cancer). There is little data on the distribution of metastatic sites in prostate cancer. The aim of this study was to describe the most common sites of metastases in prostate cancer patients.

Data from 74,826 men with metastatic prostate cancer was evaluated from a nationwide sample in the United States. 61,095 patients had a single metastatic site, while 13,734 patients had 2 or more metastatic sites.

Overall, 84% of patients had bone metastases. 10.6% of patients had metastases to distant lymph nodes while 10.2% of patients had metastases to the liver. 9.1% of patients had metastases to the thorax, 3.1% to the brain and 2.7% to the digestive system.

Of those with bone metastases (63,135 patients), 39% also had metastases in the liver, 35% in the thorax, 25% in distant lymph nodes and 12.4% in the brain.

Of those without bone metastases (11,694 patients), 41.9% had metastases to distant lymph nodes, 24.1% to the liver, 21% to the thorax and 1% to the digestive system.

Though the majority of patients with metastatic prostate cancer present with bone metastases, the proportion of patients with other sites of metastasis is not insignificant. This may be helpful when planning diagnostic imaging procedures.