Which prostate cancer patients are at risk of skeletal related events?

This study investigated whether the likelihood of developing skeletal related events (SREs) could be determined depending on the site of metastasis at diagnosis and other factors in older patients with prostate cancer.

The study concluded that the likelihood of developing an SRE was similar among different sites of metastasis, except for lymph nodes, which significantly reduced the risk. Other factors also played a role in the risk of SREs.

Metastatic prostate cancer (PC) is prostate cancer that has spread to other organs. The outcome for a PC patient depends on metastasis. The site of metastasis can impact the survival rate of patients. Common sites of metastasis include lymph nodes, bone, liver and thorax.

Bone metastasis can lead to a greater risk of skeletal related events (SREs). SREs are problems that occur with the bones, such as fractures, bone surgery, spinal cord compression and the need for radiation of the bone. It is unknown if the site of metastasis at diagnosis can be used to predict the risk of developing an SRE. Also, it is unknown if there are other factors that change the risk of developing an SRE.

This study examined the records of 4404 men with metastatic PC. 59% had metastasis to the bone at diagnosis. The men were followed for an average of 16.6 months to measure rates of SREs.

44% of all patients involved had an SRE after an average of 9.6 months. Those who had PC that had only spread to the lymph nodes when diagnosed were 44% less likely to develop an SRE compared to patients with a bone metastasis at diagnosis. Also, patients who had an unknown site of metastasis at diagnosis were 21% less likely to develop an SRE.  

Patients aged 80 and older were 17% less likely to develop an SRE. Non-Hispanic black patients were 23% less likely to develop an SRE.

Patients who had been treated with androgen deprivation therapy (treatment to decrease levels of testosterone) were 73% more likely to develop an SRE. Those who had a Gleason score of 8-10 (indicating more aggressive cancer) were 50% more likely. 

The study concluded that the likelihood of developing an SRE was similar among different sites of metastasis, except for lymph nodes, which significantly reduced the risk. Other factors also played a role in the risk of SREs. 

This method can not tell which specific patients will develop an SRE but only the likelihood of developing an SRE. 

Talk to your physician about your likelihood of experiencing an SRE.