TY - JOUR
T1 - Clinical outcomes and prognostic factors in patients with newly diagnosed metastatic prostate cancer initially treated with androgen deprivation therapy
T2 - a retrospective multicenter study in Japan
AU - Narita, Shintaro
AU - Hatakeyama, Shingo
AU - Takahashi, Masahiro
AU - Sakurai, Toshihiko
AU - Kawamura, Sadafumi
AU - Hoshi, Senji
AU - Ishida, Masanori
AU - Kawaguchi, Toshiaki
AU - Ishidoya, Shigeto
AU - Shimoda, Jiro
AU - Sato, Hiromi
AU - Koizumi, Atsushi
AU - Mitsuzuka, Koji
AU - Tochigi, Tatsuo
AU - Tsuchiya, Norihiko
AU - Ohyama, Chikara
AU - Arai, Yoichi
AU - Nomura, Kyoko
AU - Habuchi, Tomonori
N1 - Funding Information:
This study was supported in part by research grants from the MEXT/JSPS (Kakenhi, No. 19K09663).
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Purpose: Clinical outcomes of patients with newly diagnosed metastatic hormone-naïve prostate cancer (mHNPC) and initially treated with androgen deprivation therapy (ADT) were evaluated. Methods: The medical records of 605 consecutive mHNPC patients with initial ADT or combined androgen blockade (CAB) at nine study centers between 2008 and 2016 were retrospectively reviewed. Castration-resistant prostate cancer (CRPC)-free and overall survival (OS) were estimated by the Kaplan–Meier method. The association of pretreatment risk factors with CRPC-free survival and OS was evaluated by Cox proportional hazard models and differences in survival were classified by the number of risk factors. Results: Median follow-up was 2.95 years, median CRPC-free survival was 21.9 months and median OS was 5.37 years. Multivariable analysis found that four risk factors, a Gleason score ≥ 9, lymph node metastasis, an extent of disease score ≥ 2, and serum LDH of > 220 IU were independently associated with both CRPC-free survival and OS. Median CRPC-free survival of low-risk patients with no or one factor was 86.5 months, 17.9 months in intermediate-risk patients with two or three factors, and 11.0 months in high-risk patients with four factors. Median OS was 4.72 years in intermediate- and 2.44 years in high-risk patients. It was not reached in low-risk patients. Conclusion: In this series, CRPC-free and OS of a subset of mHNPC patients in Japan who were treated with ADT or CAB had better CRPC-free and overall survivals in Japan. Risk-adapted treatment based on the presence of novel prognostic factors may be beneficial for selected mHNPC patients.
AB - Purpose: Clinical outcomes of patients with newly diagnosed metastatic hormone-naïve prostate cancer (mHNPC) and initially treated with androgen deprivation therapy (ADT) were evaluated. Methods: The medical records of 605 consecutive mHNPC patients with initial ADT or combined androgen blockade (CAB) at nine study centers between 2008 and 2016 were retrospectively reviewed. Castration-resistant prostate cancer (CRPC)-free and overall survival (OS) were estimated by the Kaplan–Meier method. The association of pretreatment risk factors with CRPC-free survival and OS was evaluated by Cox proportional hazard models and differences in survival were classified by the number of risk factors. Results: Median follow-up was 2.95 years, median CRPC-free survival was 21.9 months and median OS was 5.37 years. Multivariable analysis found that four risk factors, a Gleason score ≥ 9, lymph node metastasis, an extent of disease score ≥ 2, and serum LDH of > 220 IU were independently associated with both CRPC-free survival and OS. Median CRPC-free survival of low-risk patients with no or one factor was 86.5 months, 17.9 months in intermediate-risk patients with two or three factors, and 11.0 months in high-risk patients with four factors. Median OS was 4.72 years in intermediate- and 2.44 years in high-risk patients. It was not reached in low-risk patients. Conclusion: In this series, CRPC-free and OS of a subset of mHNPC patients in Japan who were treated with ADT or CAB had better CRPC-free and overall survivals in Japan. Risk-adapted treatment based on the presence of novel prognostic factors may be beneficial for selected mHNPC patients.
KW - Androgen deprivation therapy
KW - Castration-resistant prostate cancer-free survival
KW - Hormone-naïve
KW - Hormone-sensitive
KW - Metastatic
KW - Overall survival
KW - Prostate caner
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U2 - 10.1007/s10147-019-01614-8
DO - 10.1007/s10147-019-01614-8
M3 - Article
C2 - 31919691
AN - SCOPUS:85077712862
VL - 25
SP - 912
EP - 920
JO - International Journal of Clinical Oncology
JF - International Journal of Clinical Oncology
SN - 1341-9625
IS - 5
ER -