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• W3088331243 abstract "Increasing metastatic burden is associated with worsening prognosis. However, none of the current burden definitions consider metastatic lymph node volume, number and distribution. In this exploratory analysis of cross-sectional baseline staging scans from the STAMPEDE docetaxel comparison” we evaluate metastatic lymph node burden as a prognostic factor. 629 patients with metastatic disease randomised between 2005 and 2013 to Arm A (androgen deprivation therapy (ADT)) or Arm C (ADT + docetaxel) with available baseline scans were analysed. Lymph node analysis was done using the UK Royal College of Radiologists diagnostic criteria with central review of CT/MRI scans performed jointly by a radiologist and urologist. Annotation of lymph node number and size was completed for both regional and non-regional sites. Overall survival (OS) and failure-free survival (FFS) were used as endpoints. Hazard ratios were obtained separately for each treatment group using multivariable Cox regression analysis adjusted for age (<70 or ≥70), WHO PS (0 or 1-2), nodal status (N0, N1 or NX), NSAID or aspirin use (uses either or no), Gleason score (≤7, 8-10 or unknown), bone metastases counts (<5 or ≥5) and concomitant metastatic site (only metastatic lymph nodes, bone (+/-NRLN) or any visceral (+/-bone)). 178/629 (29%) patients had nodal metastases with a median maximum diameter of 2.1 (range 1.0 to 8.1) cm and median minimum diameter of 1.2 (range 0.9 to 3.9) cm. 87/629 (14%) patients had 5 or more nodes. Patients with ≥5 metastatic nodes had worse OS compared to patients with <5 nodes in both the ADT group (HR=1.61, 95%CI 1.12–2.31, p=0.013; 5yr KM estimated OS 27% for ≥5 NRLN vs 40% for <5NRLN) and ADT + docetaxel group (HR=1.79, 95%CI 1.10–2.92, p=0.024; 5yr OS 35% vs 53%). FFS was also worse for patients with ≥5 nodes in the ADT group (HR=1.51, 95%CI 1.07–2.14, p=0.024) and the ADT + docetaxel group (HR=1.78, 95%CI 1.12–2.81, p=0.018). Increased metastatic burden of 5 or more nodal metastases is an independent prognostic factor for poorer outcomes in patients with mHSPC treated with ADT or ADT + docetaxel and should be considered for inclusion along with bone metastases counts in future metastatic burden definitions." @default.
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• W3088331243 date "2020-09-01" @default.
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• W3088331243 title "634P Impact of metastatic lymph node burden on survival in patients with mHSPC from the docetaxel comparison” of the STAMPEDE trial" @default.
• W3088331243 doi "https://doi.org/10.1016/j.annonc.2020.08.893" @default.
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