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Brain
metastasis from prostate carcinoma: The M. D. Anderson Cancer Center experience
Tremont-Lukats IW, Bobustuc G, Lagos GK, Lolas K, Kyritsis AP, Puduvalli VK
Department of Neuro-Oncology, The University of Texas M. D.
Anderson Cancer Center, Houston, Texas 77030, USA
Background. The objective of this study was to estimate the incidence and
describe distribution, clinical presentation, and prognosis of brain metastases
in patients with prostate carcinoma who were seen at The University of Texas M.
D. Anderson Cancer Center (MDACC).
Methods.
The authors reviewed the charts of 16,280 patients with prostate carcinoma in
the MDACC patient data base.
Of 131 patients with craniospinal metastases confirmed by neuroimaging (n=53
patients) or autopsy (n=78 patients), 103 of 16,280 patients (0.63%) had
parenchymal metastases.
Results.
The median patient age at diagnosis was 64 years (range, 16-85 years).
The median interval from the diagnosis of prostate carcinoma to the detection of
brain metastasis was 35 months for patients with adenocarcinoma and 48 months
for patients with small cell carcinoma (SCC).
Confusion, headache, and memory deficits were the most frequent initial
symptoms.
Eighty-six percent of patients had single lesions, and 14% of patients had >
or = 2 lesions.
Metastases were supratentorial in 81 of 103 patients (76%), infratentorial in 22
of 103 patients (21%), and both supratentorial and infratentorial in 3 of 103
patients (3%).
SCC and cribriform subtypes were more likely than adenocarcinoma to metastasize
to the brain (relative risk, 20.36; 95% confidence interval, 9.91-41.84).
Regardless of histology, the median survival in untreated patients was 1 month
compared with 3.5 months in patients who were treated with radiotherapy.
Patients who underwent stereotactic radiosurgery (n=5 patients) had a longer
median survival (9 months).
Survival was not affected by supratentorial or infratentorial location of
metastases.
Conclusions.
Brain metastasis from prostate carcinoma is a rare, terminal event with death in
<1 year frequently due to advanced, systemic disease.
The majority of metastases were single and supratentorial.
The most common clinical presentation was nonfocal neurologic symptoms related
to intracranial hypertension.
A better understanding of the biology of prostate carcinoma will help clarify
the basis for its metastasis to the brain.
Copyright 2003 American Cancer Society.
PMID: 12872358 [PubMed - in process]
Source:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12872358&dopt=Abstract
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