Size of pelvic bone metastasis as a significant prognostic factor for metastatic prostate cancer patients
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ORIGINAL ARTICLE
Size of pelvic bone metastasis as a significant prognostic factor for metastatic prostate cancer patients Toyokazu Hayakawa1 · Ken‑ichi Tabata2 · Hideyasu Tsumura2 · Shogo Kawakami1 · Takeo Katakura3 · Masatoshi Hashimoto3 · Yusuke Watanabe3 · Masatsugu Iwamura2 · Tomoyuki Hasegawa3 · Hiromichi Ishiyama1 Received: 30 March 2020 / Accepted: 4 June 2020 © Japan Radiological Society 2020
Abstract Introduction To investigate the potential prognostic value of image analysis of pelvic bone metastasis in newly diagnosed prostate cancer patients. Methods Data from 69 patients with both bone scintigraphy and pelvic CT images were selected for this analysis. Open source software (3D Slicer version 4.8.1.) was used for image analysis. Metastatic pelvic bone lesions were manually contoured, and radiomic features were extracted. As risk factors for overall survival (OS) and cause-specific survival (CSS), 105 radiomic features and clinical risk factors including age, initial prostate-specific antigen, Gleason score, TNM stage, lactate dehydrogenase (LDH), hemoglobin (Hb), alkaline phosphatase, extent of disease, visceral metastases, and radiotherapy were assessed by uni- and multivariate analyses. Results Median follow-up was 41 months (range 0–157 months). Five-year overall survival and cause-specific survival rate were 37.9% and 43.5%, respectively. After multivariate analysis, LDH, Hb, and “maximum 2D diameter” defined as maximum tumor size in the axial plane were detected as risk factors for OS. Gleason sum, LDH, and maximum 2D diameter were detected as risk factors for CSS. Conclusion Maximum 2D diameter was detected as a significant prognostic factor for metastatic prostate cancer patients. Keywords Prostate cancer · Radiomics · Bone metastasis · Computed tomography · Pelvis Abbreviations OS Overall survival CSS Cause-specific survival LDH Lactate dehydrogenase Hb Hemoglobin EOD Extent of disease ALP Alkaline phosphatase
* Hiromichi Ishiyama hishiyam@kitasato‑u.ac.jp 1
Department of Radiation Oncology, Kitasato University School of Medicine, Sagamihara, Japan
2
Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
3
Kitasato University School of Allied Health Sciences, Sagamihara, Kanagawa, Japan
Introduction Patients with metastatic prostate cancer who receive systemic treatment survive an average of approximately 5 years [1]. This survival has barely changed even in patients treated using current standards of chemotherapy [2, 3]. However, survival in these patients is highly variable depending on the metastatic site and the burden of the metastatic tumor [2, 4]. One of the reported prognostic factors for these patients is the extent of disease (EOD), based on the number of bone metastasis counted on bone scintigraphy. Other widely used prognostic factors include categories based on not only the number of bone metastases, but also metastatic site and status of visceral metastasis, as used in the CHAARTED trial [3] and STAMPEDE trial [2].
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