A novel prognostic model of de novo metastatic hormone-sensitive prostate cancer to optimize treatment intensity.

IF 2.4 3区 医学 Q3 ONCOLOGY International Journal of Clinical Oncology Pub Date : 2024-10-01 Epub Date: 2024-07-19 DOI:10.1007/s10147-024-02577-1
Hiroshi Fujiwara, Masashi Kubota, Yu Hidaka, Kaoru Ito, Takashi Kawahara, Ryoma Kurahashi, Yuto Hattori, Yusuke Shiraishi, Yusuke Hama, Noriyuki Makita, Yu Tashiro, Shotaro Hatano, Ryosuke Ikeuchi, Masakazu Nakashima, Noriaki Utsunomiya, Yasushi Takashima, Shinya Somiya, Kanji Nagahama, Takeru Fujimoto, Kosuke Shimizu, Kazuto Imai, Takehiro Takahashi, Takayuki Sumiyoshi, Takayuki Goto, Satoshi Morita, Takashi Kobayashi, Shusuke Akamatsu
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Abstract

Background: The treatment and prognosis of de novo metastatic hormone-sensitive prostate cancer (mHSPC) vary. We established and validated a novel prognostic model for predicting cancer-specific survival (CSS) in patients with mHSPC using retrospective data from a contemporary cohort.

Methods: 1092 Japanese patients diagnosed with de novo mHSPC between 2014 and 2020 were registered. The patients treated with androgen deprivation therapy and first-generation anti-androgens (ADT/CAB) were assigned to the Discovery (N = 467) or Validation (N = 328) cohorts. Those treated with ADT and androgen-receptor signaling inhibitors (ARSIs) were assigned to the ARSI cohort (N = 81).

Results: Using the Discovery cohort, independent prognostic factors of CSS, the extent of disease score ≥ 2 or the presence of liver metastasis; lactate dehydrogenase levels > 250U/L; a primary Gleason pattern of 5, and serum albumin levels ≤ 3.7 g/dl, were identified. The prognostic model incorporating these factors showed high predictability and reproducibility in the Validation cohort. The 5-year CSS of the low-risk group was 86% and that of the high-risk group was 22%. Approximately 26.4%, 62.7%, and 10.9% of the patients in the Validation cohort defined as high-risk by the LATITUDE criteria were further grouped into high-, intermediate-, and low-risk groups by the new model with significant differences in CSS. In the ARSIs cohort, high-risk group had a significantly shorter time to castration resistance than the intermediate-risk group.

Conclusions: The novel model based on prognostic factors can predict patient outcomes with high accuracy and reproducibility. The model may be used to optimize the treatment intensity of de novo mHSPC.

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用于优化治疗强度的新发转移性激素敏感性前列腺癌预后模型。
背景:新发转移性激素敏感性前列腺癌(mHSPC)的治疗和预后各不相同。我们利用当代队列的回顾性数据,建立并验证了预测 mHSPC 患者癌症特异性生存率(CSS)的新型预后模型。接受雄激素剥夺疗法和第一代抗雄激素(ADT/CAB)治疗的患者被分配到发现队列(N = 467)或验证队列(N = 328)。接受ADT和雄激素受体信号转导抑制剂(ARSIs)治疗的患者被分配到ARSI队列(N = 81):利用发现队列,确定了CSS、疾病程度评分≥2或存在肝转移、乳酸脱氢酶水平>250U/L、原发性Gleason模式为5和血清白蛋白水平≤3.7 g/dl等独立预后因素。包含这些因素的预后模型在验证队列中显示出较高的可预测性和可重复性。低风险组的 5 年 CSS 为 86%,高风险组为 22%。在根据 LATITUDE 标准定义为高风险的验证队列中,约有 26.4%、62.7% 和 10.9% 的患者被新模型进一步分为高风险组、中风险组和低风险组,且 CSS 存在显著差异。在ARSIs队列中,高危组抗阉时间明显短于中危组:结论:基于预后因素的新模型可以预测患者的预后,准确性和可重复性都很高。结论:基于预后因素的新型模型可预测患者的预后,准确性高且可重复性好,该模型可用于优化新发 mHSPC 的治疗强度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.80
自引率
3.00%
发文量
175
审稿时长
2 months
期刊介绍: The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.
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