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Impact of number of bone metastases on cancer control outcomes in mHSPC, independent of the axial-skeleton CHAARTED definition

Objective - Patient and treatment stratification for metastatic hormone-sensitive prostate cancer (mHSPC) is usually based on metastatic burden according to CHAARTED criteria, classifying high-volume disease as at least 4 bone metastases, one outside the axial skeleton, or one visceral metastasis. W...

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Main Authors: Wenzel, Mike (Author) , Theissen, Lena (Author) , Siech, Carolin (Author) , Lauer, Benedikt (Author) , Winkler, Sophia (Author) , Filzmayer, Maximilian (Author) , Le, Chi (Author) , Humke, Clara (Author) , Kriegmair, Maximilian (Author) , Steuber, Thomas (Author) , Chun, Felix K. H. (Author) , Mandel, Philipp (Author)
Format: Article (Journal)
Language:English
Published: September 2026
In: Urologic oncology
Year: 2026, Volume: 44, Issue: 9, Pages: 497-504
ISSN:1873-2496
DOI:10.1016/j.urolonc.2026.06.018
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.urolonc.2026.06.018
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S1078143926005764
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Author Notes:Mike Wenzel, M.D., Lena Theissen, M.D., Carolin Siech, M.D., Benedikt Lauer, M.D., Sophia Winkler, M.D., Maximilian Filzmayer, M.D., Chi Le, M.D., Clara Humke, M.D., Maximilian Kriegmair, M.D., Thomas Steuber, M.D., Felix K. H. Chun, M.D., Philipp Mandel, M.D.
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Summary:Objective - Patient and treatment stratification for metastatic hormone-sensitive prostate cancer (mHSPC) is usually based on metastatic burden according to CHAARTED criteria, classifying high-volume disease as at least 4 bone metastases, one outside the axial skeleton, or one visceral metastasis. We aimed to examine the impact of the number of bone metastases independently of CHAARTED criteria. - Material and Methods - Using the FRAMCAP (FRAnkfurt Metastatic Cancer database of the Prostate), time to castration resistant prostate cancer (ttCRPC) and overall survival (OS) were analyzed in patients with mHSPC stratified into 1 to 3 vs. 4 to 7 vs. ≥8 bone metastases, irrespective of axial skeletal location. Comparisons were made against CHAARTED low- and high-volume mHSPC outcomes. - Results - Of 398 patients with mHSPC, 43% harbored 1 to 3, 19% 4 to 7 and 38% ≥8 bone metastases. CHAARTED high-volume mHSPC was diagnosed in 52%. Median ttCRPC was lowest for ≥8 bone metastases (16.2 months), followed by 4 to 7 (17.3 months) and 1 to 3 bone metastases (28.4 months; P < 0.01). Similar ttCRPC outcomes were observed when stratification was made into CHAARTED low- (28.4 months) vs. high-volume mHSPC (17.2 months). Median OS was also significantly shorter for ≥8 bone metastases (34.5 months), followed by 4 to 7 (53.3 months), and 1 to 3 (56.4 months; P < 0.001). Comparable OS outcomes were observed in CHAARTED low- (58.3 months) vs. high-volume mHSPC (43.4 months). - Conclusion - The number of bone metastases, regardless of their localization in the axial skeleton, has a significant influence on cancer-control outcomes. Especially, patients with ≥4 bone metastases have comparable outcomes to CHAARTED high-volume patients with mHSPC with at least one metastasis outside the axial skeleton.
Item Description:Online verfügbar: 12. Juli 2026, Artikelversion: 19. August 2026
Gesehen am 01.09.2026
Physical Description:Online Resource
ISSN:1873-2496
DOI:10.1016/j.urolonc.2026.06.018

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