Brain metastases are an uncommon yet life-limiting manifestation of prostate cancer. However, there is limited insight into the natural progression, therapeutics, and patient outcomes for prostate cancer once metastasized to the brain. This is a retrospective study of 461 patients with metastatic prostate cancer to the brain with a primary outcome of median overall survival (OS). The Surveillance, Epidemiology, and End Results (SEER) database was examined using Cox regression univariate and multivariable analyses, and a corresponding nomogram was developed. The median overall survival was 15 months. In the multivariable analysis, Hispanic patients had significantly increased OS (median OS 17 months, p = 0.005). Patients with tumor sizes greater than three centimeters exhibited significantly reduced OS (median OS 19 months, p = 0.014). Patients with additional metastases to the liver exhibited significantly reduced OS (median OS 3.5 months, p < 0.001). Increased survival was demonstrated in patients treated with chemotherapy or systemic treatment (median OS 19 months, p = 0.039), in addition to radiation and chemotherapy (median OS 25 months, p = 0.002). The nomogram had a C-index of 0.641. For patients with prostate metastases to the brain, median OS is influenced by race, tumor size, presence of additional metastases, and treatment. The lack of an association between traditional prostate cancer prognosis metrics, including Gleason and ISUP grading, and mortality highlights the need for individualized, metastasis-specific prognosis metrics. This prognostic nomogram for prostate metastases to the brain can be used to guide the management of affected patients.

Background Esthesioneuroblastoma (ENB) is a rare neuroectodermal tumor arising from the ol-factory epithelium. This study aimed to identify survival determinants and construct a prognostic web-based nomogram using the Surveillance, Epidemiology, and End Results (SEER) database records. Methods The SEER database, including 18 registries across the nation, was queried for patients diagnosed with ENB between 2000 and 2020. Patient demographics, tumor characteristics, and treatment data were analyzed using Cox Proportional Hazard models and Kaplan-Meier based survival plots. A web-based nomogram was constructed to predict 5- and 10-year survival proba-bilities individualized to a specific patient. Results 941 patients were included in this analysis. Overall survival rates at 1-, 2-, 5-, and 10-years were 89%, 85%, 75%, and 58%, respectively. Multivariable analysis showed worse OS associated with age > 50 (p< 0.001) and tumor size >6.0 cm (p< 0.01). Compared to patients treated with gross total resection (GTR), worse OS was observed in those treated with chemotherapy (CT) only (p< 0.01), CT and radiation (RT, p< 0.01), GTR + CT (p< 0.05), RT only (p< 0.01), or no treatment (p< 0.001). No statistically significant differences in OS were observed for patients treated with GTR + RT, GTR + RT + CT, subtotal resection (STR), or STR with adjuvant therapies when compared to GTR alone. Our web-based nomogram is publicly available (link). This model demonstrated a strong predictive performance, with a C-index of 0.733±0.041 and AUC of 0.747. Conclusion This is currently the largest retrospective cohort study to analyze survival determinants in patients with ENB. This is the first nomogram-based app developed for this specific patient population. We hope this will help guide clinicians to have more meaningful discussions with their patients and employ evidence-based practices.

Background: Esthesioneuroblastoma (ENB) is a rare neuroectodermal tumor arising from the olfactory epithelium. This study aimed to identify survival determinants and construct a prognostic web-based nomogram to provide individualized survival predictions for ENB patients. Methods: Patients diagnosed with ENB between 2000 and 2022 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. Patient demographics, tumor characteristics, and treatment data were analyzed using Cox proportional hazards models and Kaplan–Meier survival curves. A web-based nomogram was constructed to predict 5- and 10-year survival probabilities individualized to a specific patient. Results: Nine hundred and forty-one ENB patients were analyzed. Overall survival (OS) rates at 1-, 2-, 5-, and 10-years were 89%, 85%, 75%, and 58%, respectively. Multivariable analysis revealed that age over 50 (p < 0.001) and tumor size over 6.0 cm (p < 0.01) were independent predictors of worse OS. Compared to patients treated with gross total resection (GTR) alone, worse OS was observed in those treated with chemotherapy (CT) only (p < 0.01), CT and radiation (RT, p < 0.01), GTR + CT (p < 0.05), RT only (p < 0.01), or no treatment (p < 0.001). No statistically significant differences in OS were found between GTR alone and GTR + RT, GTR + RT + CT, subtotal resection (STR), or STR with adjuvant therapies. The resulting ENB prognostic nomogram demonstrated acceptable predictive performance, with a C-index of 0.733 ± 0.041 and AUC of 0.749. Conclusions: Age and tumor size are critical survival determinants in ENB, and GTR continues to be the foundational treatment. The developed prognostic web-based nomogram successfully quantifies individualized survival probabilities, providing clinicians with a tailored tool to guide evidence-based counseling and management for ENB patients.