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Review
. 2022 Jul 18;11(14):4165.
doi: 10.3390/jcm11144165.

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

Kobisha Rajeswaran  1 , Kaitlin Muzio  1 , Juan Briones  2 , Mary Jane Lim-Fat  3 , Chia-Lin Tseng  4 , Martin Smoragiewicz  1   5 , Jay Detsky  4 , Urban Emmenegger  1   5   6   7
Affiliations
Review

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

Kobisha Rajeswaran et al. J Clin Med. .

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.

Keywords: brain metastasis; outcome; prostatic neoplasms; systematic literature review; treatment.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of the data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flow diagram of selected publications. PubMed, MEDLINE, and EMBASE databases were searched. Publications were filtered by title, abstract, and exclusion criteria.
Figure 2
Figure 2
(A–C) Publication characteristics: the selected articles were analyzed to understand the characteristics regarding the country of study, temporal publication trends, as well as the number of patients per study and source of patient information. (A) Publication by country of study: number of publications by country of study. (B) Publication by year: depiction of the number of publications per five-year intervals. (C) Publication by patient selection: number of patients per study and assignment of publications to the following sources of information: autopsy reviews, case series, retrospective chart reviews, or administrative database search [4,5,7,9,10,11,12,13,14,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47].
Figure 2
Figure 2
(A–C) Publication characteristics: the selected articles were analyzed to understand the characteristics regarding the country of study, temporal publication trends, as well as the number of patients per study and source of patient information. (A) Publication by country of study: number of publications by country of study. (B) Publication by year: depiction of the number of publications per five-year intervals. (C) Publication by patient selection: number of patients per study and assignment of publications to the following sources of information: autopsy reviews, case series, retrospective chart reviews, or administrative database search [4,5,7,9,10,11,12,13,14,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47].
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