Prostate Cancer Brain Metastasis: Review of a Rare Complication with Limited Treatment Options and Poor Prognosis

Abstract

Brain metastases (BM) are perceived as a rare complication of prostate cancer associated with poor outcome. Due to limited published data, we conducted a literature review regarding incidence, clinical characteristics, treatment options, and outcomes of patients with prostate cancer BM. A literature analysis of the PubMed, MEDLINE, and EMBASE databases was performed for full-text published articles on patients diagnosed with BM from prostate cancer. Eligible studies included four or more patients. Twenty-seven publications were selected and analyzed. The sources of published patient cohorts were retrospective chart reviews, administrative healthcare databases, autopsy records, and case series. BM are rare, with an incidence of 1.14% across publications that mainly focus on intraparenchymal metastases. Synchronous visceral metastasis and rare histological prostate cancer subtypes are associated with an increased rate of BM. Many patients do not receive brain metastasis-directed local therapy and the median survival after BM diagnosis is poor, notably in patients with multiple BM, dural-based metastases, or leptomeningeal dissemination. Overall, prostate cancer BM are rare and associated with poor prognosis. Future research is needed to study the impact of novel prostate cancer therapeutics on BM incidence, to identify patients at risk of BM, and to characterize molecular treatment targets.

Brain metastases as the first clinical manifestation of prostate cancer: a case report

“…(2022 г. ), составила 0,76-1,26% [6]. Такая редкость подобных случаев обусловлена, вероятно, инфратенториальным расположением метастазов.…”

“…(2022 г. ), частота выявления метастазов в ГМ у нелеченных больных на диагностическом этапе составляет 0,76-1,26% [6].M. Ganau и соавт.…”

The Successful Treatment of a Case of Prostate Cancer With Brain Metastasis at Diagnosis

“…We presented a unique case of prostate cancer with brain metastasis with a surprisingly good prognosis following management with a multimodal approach. Brain metastasis is not common in prostate cancer, and it very rarely presents synchronously with the primary tumor and with the brain as the only site of metastasis [ 3 ]. In this scenario, the neoplasms that typically metastasize to the CNS, such as breast, melanoma, and lung cancer were excluded upfront, and it was only through histology and immunohistochemistry that we were able to discover the primary tumor.…”

“…Based on the performance status, systemic disease involvement, and presentation, surgery, radiotherapy, or chemotherapy can be possible treatment options [ 1 - 4 , 7 ]. Apart from the number, the location of the brain metastasis also appears to have a prognostic impact, with intraparenchymal metastasis having a better prognosis than dural and leptomeningeal variants [ 3 , 5 , 7 ]. We report a rare case of oligometastatic prostate cancer presenting with headache and vomiting with a surprisingly favorable prognosis after a multimodal management approach.…”

The Complexity of Treatments and the Multidisciplinary Team—A Rare Case of Long-Term Progression—Free Survival in Prostate Cancer until Development of Liver and Brain Metastases

“…Clinically, presentation ranges from a localized asymptomatic form within a low-risk group disease to aggressive disease with distance dissemination. Approximately 17% of prostate cancers lead to metastases, the most frequent location being the bony skeleton (approximately 85%), followed by the lymph nodes, liver, and lungs (approximately 10%) [3,4].…”