Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Lymph-Nodal Oligometastases from Prostate Cancer: Different Outcomes and Pattern of Relapse between Pelvic and Para-Aortic Disease

Edoardo Pastorello
,
Luca Nicosia
* ,
Luca Triggiani
,
Francesco Frassine
,
Paola Vitali
,
Emiliano Salah El Din El Tantawy
,
Valeria Santoro
,
Michele Rigo
,
Simona Gaito
,
Renzo Mazzarotto
,
Michela Buglione di Monale e Bastia
,
Filippo Alongi
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Version 1 : Received: 29 February 2024 / Approved: 29 February 2024 / Online: 29 February 2024 (13:09:45 CET)

How to cite: Pastorello, E.; Nicosia, L.; Triggiani, L.; Frassine, F.; Vitali, P.; Salah El Din El Tantawy, E.; Santoro, V.; Rigo, M.; Gaito, S.; Mazzarotto, R.; Buglione di Monale e Bastia, M.; Alongi, F. Lymph-Nodal Oligometastases from Prostate Cancer: Different Outcomes and Pattern of Relapse between Pelvic and Para-Aortic Disease. Preprints 2024, 2024021720. https://doi.org/10.20944/preprints202402.1720.v1 Pastorello, E.; Nicosia, L.; Triggiani, L.; Frassine, F.; Vitali, P.; Salah El Din El Tantawy, E.; Santoro, V.; Rigo, M.; Gaito, S.; Mazzarotto, R.; Buglione di Monale e Bastia, M.; Alongi, F. Lymph-Nodal Oligometastases from Prostate Cancer: Different Outcomes and Pattern of Relapse between Pelvic and Para-Aortic Disease. Preprints 2024, 2024021720. https://doi.org/10.20944/preprints202402.1720.v1

Abstract

Introduction: Lymph-nodal prostate cancer oligometastases are differently treated according to their site: pelvic are locoregional lymph-nodes, instead para-aortic lymph-nodes are considered as distant metastases. Aim of the study was a comparison between para-aortic and pelvic oligometastases treated with stereotactic body radiation therapy (SBRT). Material/methods: This is a retrospective analysis. De-novo metastatic or extra-nodal disease were excluded. Univariate and multivariate analyses were performed; pattern of recurrence was evaluated too. A propensity score matching (PSM) was applied to create comparable cohorts. Primary end-point was the progression-free survival (PFS). Secondary end-points were biochemical relapse-free survival (BRFS), ADT-free survival (ADTFS), polymetastases-free survival (PMFS), local progression-free survival (LPFS) and pattern of relapse. Results: 240 lymph-nodal oligometastases in 164 patients (127 pelvic and 37 para-aortic) were treated. Median PFS was 20 and 11 months in pelvic and para-aortic patients respectively (p=0.042). The difference was not confirmed at the multivariate analysis (p=0.06). Median BRFS was 16 and 9 months respectively in pelvic and para-aortic group (p=0.07). No statistically significant differences for ADTFS or PMFS were detected. The cumulative 5-years LPFS was 90.5%. At PSM no statistically significant differences for all the study end-points were detected. Conclusions: Patients affected by para-aortic disease might have PFS comparable to pelvic disease; local control is high in both cohorts. Our results support the use of SBRT also to para-aortic metastases.

Keywords

SBRT; oligometastases; prostate cancer; SABR

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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