Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Oct 6;15(10):e46598.
doi: 10.7759/cureus.46598. eCollection 2023 Oct.

Metastatic Prostate Cancer to the Optic Canal: A Large-Cohort Analysis

Neil Kelkar  1 , Dawood Findakly  2 , Jue Wang  3
Affiliations
Review

Metastatic Prostate Cancer to the Optic Canal: A Large-Cohort Analysis

Neil Kelkar et al. Cureus. .

Abstract

Prostate cancer (PCa) can present with metastases in rare cases, including those to the optic canal. Currently, no guidelines exist for managing PCa metastases in this patient population. This article aims to examine optic canal metastases through a large-cohort analysis. It involves a systematic review of the literature through a pooled analysis of published cases of PCa with optic canal or orbital metastasis, including one case previously reported from our institution. A subgroup analysis was employed to compare cases with optic metastases as their initial PCa presentation, hormone-naive (HN), versus those with optic metastases after PCa diagnosis, hormone-refractory (HR). A total of 45 patients with ocular metastasis from PCa were included in this study. The mean age at diagnosis overall was 66.8 years (range: 45-85 years). Moreover, 16 cases (50%) had deceased, with a median time-to-death of 22 (range: 2-84) months. Regarding subgroup analysis, the mean age at diagnosis was 69.5 years (53-85 years) in the HN group and 64.5 years (45-83 years) in the HR group. With regard to reported survival, 10 (62.5%) cases belonged to the HN subset with a median follow-up duration of 12 (range: 1.5-36) months. In terms of reported mortality, 10 (62.5%) were from the HR subset with a median time-to-death of 32.5 (range 0.5-84) months. Our study constitutes the largest and most comprehensive examination of patients with optic canal metastases due to PCa so far. While optic canal metastases are a rare manifestation of PCa, they are linked with a poor prognosis. We also observed significant differences between HR and HN cohorts, which may indicate a difference in clinical presentations.

Keywords: anti-androgen therapy; metastatic prostate cancer; optic canal metastasis; orbital metastasis; prostate cancer.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA flowchart depicting the selection of cases
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Figure 2
Figure 2. Survival curve of patients with optic canal metastases due to prostate cancer
Figure 3
Figure 3. Breakdown of reported Gleason scores
See this image and copyright information in PMC

References

    1. Association of reductions in PSA screening across states with increased metastatic prostate cancer in the United States. Sharma V, Venkataramana A, Comulada WS, Litwin MS, Saigal C. J Clin Oncol. 2021;39:228.
    1. Cancer statistics, 2022. Siegel RL, Miller KD, Fuchs HE, Jemal A. CA Cancer J Clin. 2022;72:7–33. - PubMed
    1. Ocular involvement in metastatic and systemic malignancies is not rare. Sthapit PR, Saiju R. Cancer Rep (Hoboken) 2021;4:0. - PMC - PubMed
    1. Orbital metastases from prostate carcinoma. Boldt HC, Nerad JA. Arch Ophthalmol. 1988;106:1403–1408. - PubMed
    1. Metastatic prostate cancer to the optic canal. Kattah JC, Chrousos GC, Roberts J, Kolsky M, Zimmerman L, Manz H. Ophthalmology. 1993;100:1711–1715. - PubMed

LinkOut - more resources