Survival study of cytoreductive prostatectomy for prostate cancer with lung metastasis: A propensity score matching study based on the SEER database

Abstract

Objective To investigate the specific tumor survival situation of cytoreductive prostatectomy for prostate cancer with lung metastasis. Methods Case data of prostate cancer patients diagnosed from 2010 to 2015 were collected from the SEER database ( https://seer.cancer.gov/ ) to obtain age, race, marital status, T stage, N stage, ISUP grade, prostate-specific antigen level (PSA), surgery, radiotherapy, chemotherapy, and survival time. The subjects were divided into surgical groups (CDS): resection of the primary lesion (prostate) and non-surgical groups (NCDS). The purpose of palliative debulking is to reduce the tumor burden. Only the primary lesion of the prostate is removed, while metastatic lesions are not subjected to surgical resection. Propensity score matching (PSM) was used to control confounding factors, and the survival outcomes of the two groups were systematically evaluated. Kaplan-Meier survival curves and forest plots were plotted to further verify the survival benefits of the surgery. Results A total of 808,782 cases were screened through the SEER database, and ultimately 1548 cases were eligible for prostate cancer with lung metastasis, including 136 cases in the surgical group and 1412 cases in the non-surgical group. After PSM, there were 70 cases in the surgical group and 70 cases in the non-surgical group. The Kaplan-Meier survival curve showed no survival difference between the two groups, P = 0.28, and the forest plot further confirmed no survival difference between the two groups. The Kaplan-Meier survival curve analysis for the subgroups that received further radiotherapy and chemotherapy showed that there was no statistically significant difference in the tumor-specific survival time among the subgroups (P > 0.05). Conclusion Cytoreductive prostatectomy does not prolong the specific tumor survival time of prostate cancer patients with lung metastasis, Radiotherapy and chemotherapy also fail to extend the specific tumor survival time for these patients.