Time to progression to castration-resistant prostate cancer after commencing combined androgen blockade for advanced hormone-sensitive prostate cancer

Abstract

PurposeThe aim of our retrospective study was to determine the time to progression to castration-resistant prostate cancer (CRPC) in prostate cancer patients who undergo combined androgen blockade (CAB), as well as their prognoses.Materials and MethodsWe examined the overall survival (OS) and disease-specific survival rates, as well as the time to CRPC development, in 387 patients who were treated with CAB for prostate cancer. The disease-specific survival rate and time to CRPC were stratified by prostate-specific antigen (PSA) levels, Gleason score (GS), and presence of metastasis at diagnosis. We designated high-risk patients as those satisfying at least two of the following three criteria: extent of disease of bone metastasis grade ≥2, presence of metastasis at diagnosis, and a GS ≥8.ResultsThe 10- and 15-year OS rates were 74.0% and 50.4%, respectively, while the corresponding disease-specific survival rates were both 86.8%. Metastasis at diagnosis was an independent prognostic factor for disease-specific survival. The median time to CRPC development was 140.7 months. A PSA level ≥20 ng/mL, a GS ≥8, and the presence of metastasis at diagnosis were independent predictors of a shorter time to CRPC development. The 10-year disease-specific survival rate in the high-risk group was significantly lower than that in the low-risk group (approximately 74% vs. 98%), and the time to CRPC development was significantly shorter (median: 20.5 months vs. not reached).ConclusionsThe time to CRPC development was shorter in high-risk prostate cancer patients with metastases. Such patients require alternative novel treatment modalities.

Impact of Time to Castration Resistance on Survival in Metastatic Hormone Sensitive Prostate Cancer Patients in the Era of Combination Therapies

“…Additionally, several studies aimed to investigate risk factors for progression to mCRPC in mHSPC patients. Several risk factors such as PSA, Gleason score, or time to PSA nadir in mHSPC treatment were found to be such predictors (21)(22)(23)(24)(25)(26). Despite non-significant differences between the four examined TTCR subgroups, possibly due to sample size limitations, we also found interesting trends.…”

Artificial Intelligence-based Personalized and Risk-adapted Surveillance Management for Urologic Cancer: A SEER-based Study

“…We identified that the observation intervals (red area in Figure 5) suggested by our algorithms covered the first 5 years mostly considered by the current clinical guidelines and the follow-up plan practices 23 . Further, our approach has covered the time beyond 5 years where we do not have data from studies on the optimal observation management for urologic cancer diseases.…”

Prevalence of Prostate Cancer at Different Clinical Stages in Italy: Estimated Burden of Disease Based on a Modelling Study

“…Internal validation of the model was performed by comparing our estimated total prevalence of the PC cases in Italy in 2018 to the AIOM-AIRTUM data [6]. Various studies provided information on the probability of transition from a clinical stage to another one, or to death [16][17][18][19][20][21][22][23]. These are reported, together with the corresponding probabilities, in Table 1.…”