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World Journal of Urology
Published in: World Journal of Urology 11/2019

01-11-2019 | Prostate Cancer | Original Article

Impact of nadir PSA level and time to nadir during initial androgen deprivation therapy on prognosis in patients with metastatic castration-resistant prostate cancer

Authors: Itsuto Hamano, Shingo Hatakeyama, Shintaro Narita, Masahiro Takahashi, Toshihiko Sakurai, Sadafumi Kawamura, Senji Hoshi, Masanori Ishida, Toshiaki Kawaguchi, Shigeto Ishidoya, Jiro Shimoda, Hiromi Sato, Koji Mitsuzuka, Tatsuo Tochigi, Norihiko Tsuchiya, Yoichi Arai, Tomonori Habuchi, Chikara Ohyama

Published in: World Journal of Urology | Issue 11/2019

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Abstract

Purpose

We determine whether the nadir prostate-specific antigen level (PSA nadir) and time to nadir (TTN) during initial androgen deprivation therapy (ADT) are prognostic factors in metastatic castration-resistant prostate cancer (mCRPC) patients.

Methods

We reviewed the Michinoku Japan Urological Cancer Study Group database, including 321 mCRPC patients. Optimal cutoff values for PSA nadir and TTN on survival were calculated with the receiver operating characteristic (ROC) curve. Patients were stratified into unfavorable (higher PSA nadir and/or shorter TTN) and favorable (lower PSA nadir and longer TTN) groups. The inversed probability of treatment weighing (IPTW)-adjusted Cox proportional hazard model was performed to evaluate the impact of the unfavorable group on overall survival (OS) after CRPC diagnosis.

Results

Median age and follow-up period were 71 years and 35 months, respectively. ROC curve analysis demonstrated cutoffs of PSA nadir > 0.64 ng/mL and TTN < 7 months. The unfavorable group included 248 patients who had significantly shorter OS after mCRPC. The IPTW-adjusted multivariate model revealed that the unfavorable group had a negative impact on OS in mCRPC patients [hazards ratio (HR) 2.98, P < 0.001].

Conclusions

Higher PSA nadir and shorter TTN during the initial ADT are poor prognostic factors in patients with mCRPC.
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Metadata
Title
Impact of nadir PSA level and time to nadir during initial androgen deprivation therapy on prognosis in patients with metastatic castration-resistant prostate cancer
Authors
Itsuto Hamano
Shingo Hatakeyama
Shintaro Narita
Masahiro Takahashi
Toshihiko Sakurai
Sadafumi Kawamura
Senji Hoshi
Masanori Ishida
Toshiaki Kawaguchi
Shigeto Ishidoya
Jiro Shimoda
Hiromi Sato
Koji Mitsuzuka
Tatsuo Tochigi
Norihiko Tsuchiya
Yoichi Arai
Tomonori Habuchi
Chikara Ohyama
Publication date
01-11-2019
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 11/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-019-02664-3

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