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, 9 (97), 36966-36974

Time to Progression to Castration-Resistant Prostate Cancer After Commencing Combined Androgen Blockade for Advanced Hormone-Sensitive Prostate Cancer

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Time to Progression to Castration-Resistant Prostate Cancer After Commencing Combined Androgen Blockade for Advanced Hormone-Sensitive Prostate Cancer

Satoshi Tamada et al. Oncotarget.

Abstract

Purpose: The 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 methods: We 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.

Results: The 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).

Conclusions: The time to CRPC development was shorter in high-risk prostate cancer patients with metastases. Such patients require alternative novel treatment modalities.

Keywords: castration-resistant prostate cancer; combined androgen blockade; hormone-sensitive prostate cancer; progression; survival.

Conflict of interest statement

CONFLICTS OF INTEREST T. Iguchi and T. Nakatani have received research funding from Astellas Japan (Tokyo, Japan), Bayer Yakuhin. Ltd (Osaka, Japan). The remaining authors have declared no conflict of interest.

Figures

Figure 1
Figure 1
The disease-specific survival rate was stratified by the presence of metastatic foci (A), prostate-specific antigen (PSA) levels at diagnosis (<20 ng/mL vs. ≥20 ng/mL) (B), and the Gleason score (≤7 vs. ≥8) (C).
Figure 2
Figure 2. The time to developing castration-resistant prostate cancer among the 387 patients with prostate cancer treated by combined androgen blockade
Figure 3
Figure 3
The time to developing castration-resistant prostate cancer was stratified by the presence of metastatic foci (A), prostate-specific antigen (PSA) levels at diagnosis (<20 ng/mL vs. ≥20 ng/mL) (B), and Gleason score (≤7 vs. ≥8) (C).
Figure 4
Figure 4. The disease-specific survival rate classified by the extent of disease (EOD) grade (0, 1, or ≥2)
Figure 5
Figure 5
(A) Disease-specific survival in the low- and high-risk patient groups. (B) Time to progression to castration-resistant prostate cancer in the low- and high-risk patient groups.

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