Development and Validation of a Novel Prognostic Model for Predicting Overall Survival in Treatment-naïve Castration-sensitive Metastatic Prostate Cancer

Akamatsu, Shusuke; Kubota, Masashi; Uozumi, Ryuji; Narita, Shintaro; Takahashi, Masahiro; Mitsuzuka, Koji; Hatakeyama, Shingo; Sakurai, Toshihiko; Kawamura, Sadafumi; Ishidoya, Shigeto; Hoshi, Senji; Ishida, Masanori; Mizuno, Kei; Ogura, Keiji; Goto, Takayuki; Terada, Naoki; Kobayashi, Takashi; Yamasaki, Toshinari; Inoue, Takahiro; Tsuchiya, Norihiko; Οhyama, Chikara; Arai, Yoichi; Habuchi, Tomonori; Morita, Satoshi; Ogawa, Osamu

doi:10.1016/j.euo.2018.10.011

Cited by 46 publications

(55 citation statements)

References 29 publications

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“…17 Recently, a primary GS ≥5 was reported as an independent predictor of poor OS in Japanese mCNPC patients. 18 In our study, GS ≥ 9 provided an independent prognostic factor after multivariate analysis. Further investigation of clinical factors other than tumor burden for identifying high-risk metastatic PCa is needed.…”

Section: Discussionsupporting

confidence: 53%

“…Since the exposure rate for PSA screening is still lower than that in the United States, Japanese cohorts have been reported to be diagnosed with high GS 17 . Recently, a primary GS ≥5 was reported as an independent predictor of poor OS in Japanese mCNPC patients 18 . In our study, GS ≥ 9 provided an independent prognostic factor after multivariate analysis.…”

Section: Discussionsupporting

confidence: 51%

“…In our analysis, visceral metastasis was not a significant predictor of OS, probably because the majority of patients had lung metastasis, and relatively few patients displayed liver metastasis. Since another large‐scale cohort analysis in Asia reported that liver metastasis, rather than simply visceral metastasis, offered an independent prognostic factor, 18 further investigation is required to more properly classify “high‐volume” and “high‐risk” metastatic PCa with respect to visceral metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…Visceral metastasis shows wide heterogeneity and the poor prognosis of cases with liver metastasis is well known while patients with lung-only metastasis present considerably more favorable clinical outcomes from ADT. 18,19 A previous study showed that patients with pulmonary-only metastatic PCa have the potential to demonstrate unique molecular characteristics with a high frequency of mismatch repair and homologous-recombination deficiency mutations. 19 In our analysis, visceral metastasis was not a significant predictor of OS, probably because the majority of patients had lung metastasis, and relatively few patients displayed liver metastasis.…”

Section: Discussionmentioning

confidence: 99%

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How many bone metastases may be defined as high‐volume metastatic prostate cancer in Asians: A retrospective multicenter cohort study

et al. 2020

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Background Recent landmark randomized trials (CHAARTED and LATITUDE studies) have highlighted potent upfront therapy for “high‐volume” and “high‐risk” metastatic castration‐naïve prostate cancer (mCNPC). However, treatment response shows racial differences. We aimed to propose a novel definition for “high‐volume” prostate cancer in Asians. Methods We retrospectively pursued 426 patients with de novo mCNPC from multiple institutions between 1999 and 2017. All patients received androgen deprivation therapy alone as initial treatment. We evaluated the number of bone metastases at diagnosis to clarify the clinical significance for progression‐free survival and overall survival (OS). Statistical analyses were conducted using the Mann‐Whitney U test, Cox proportional hazard models, and Kaplan‐Meier methods. Results Median age and prostate‐specific antigen level were 73 years and 266.2 ng/ml, respectively. Median OS was 55.5 months in patients who met the CHAARTED high criteria (vs 33.1 months in the trial). We evaluated 5 thresholds in the number of bone metastases (≥4, ≥6, ≥11, ≥16, and ≥21) to investigate the prognostic values. Patients with ≥11 bone metastases showed the highest HR for OS (2.766). Patients with 11 to 20 bone metastases had a significantly shorter OS than those with ≤10 metastases (P = .0001). We, therefore, proposed modified CHAARTED and LATITUDE high criteria (extending bone metastases ≥11). In multivariate analysis, the modified criteria were the only independent prognostic factors for OS (P = .0272 and P = .042, respectively). Conversely, no significant differences in OS were seen between patients with 1 to 3 bone metastases and 4 to 10 (P = .7513). Conclusion Our exploratory study suggested ≥11 bone metastases as a suitable definition for “high‐volume” prostate cancer in Asians. A larger, prospective study is warranted to verify our findings.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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How many bone metastases may be defined as high‐volume metastatic prostate cancer in Asians: A retrospective multicenter cohort study

et al. 2020

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“…Bone metastatic tumor burden is one of the most influential prognostic markers in patients with mHNPC . In large randomized trials that showed the benefit of upfront therapy using docetaxel and abiraterone acetate with ADT in patients with mHNPC, the number of bone metastases was one of the specific factors used for dichotomizing risk groups for prognosis .…”

Section: Discussionmentioning

confidence: 99%

Changes in conditional net survival and dynamic prognostic factors in patients with newly diagnosed metastatic prostate cancer initially treated with androgen deprivation therapy

et al. 2019

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Background The purpose of this study was to identify predictive factors associated with conditional net survival in patients with metastatic hormone‐naive prostate cancer (mHNPC) initially treated with androgen deprivation therapy (ADT). Methods At nine hospitals in Tohoku, Japan, the medical records of 605 consecutive patients with mHNPC who initially received ADT were retrospectively reviewed. The Pohar Perme estimator was used to calculate conditional net cancer‐specific survival (CSS) and overall survival (OS) for up to 5 years subsequent to the diagnosis. Using multiple imputation, proportional hazard ratios for conditional CSS and OS were calculated with adjusted Cox regression models. Results During a median follow up of 2.95 years, 208 patients died, of which 169 died due to progressive prostate cancer. At baseline, the 5‐year CSS and OS rates were 65.5% and 58.2%, respectively. Conditional 5‐year net CSS and OS survival gradually increased for all the patients. In patients given a 5‐year survivorship, the conditional 5‐year net CSS and OS rates improved to 0.906 and 0.811, respectively. Only the extent of disease score (EOD) ≥2 remained a prognostic factor for CSS and OS up to 5 years; as survival time increased, other variables were no longer independent prognostic factors. Conclusions The conditional 5‐year net CSS and OS in patients with mHNPC gradually increased; thus, the risk of mortality decreased with increasing survival. The patient's risk profile changed over time. EOD remained an independent prognostic factor for CSS and OS after 5‐year follow‐up. Conditional net survival can play a role in clinical decision‐making, providing intriguing information for cancer survivors.

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A novel prognostic model for Japanese patients with newly diagnosed bone‐metastatic hormone‐naïve prostate cancer

et al. 2020

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Development and Validation of a Novel Prognostic Model for Predicting Overall Survival in Treatment-naïve Castration-sensitive Metastatic Prostate Cancer

Cited by 46 publications

References 29 publications

How many bone metastases may be defined as high‐volume metastatic prostate cancer in Asians: A retrospective multicenter cohort study

How many bone metastases may be defined as high‐volume metastatic prostate cancer in Asians: A retrospective multicenter cohort study

Changes in conditional net survival and dynamic prognostic factors in patients with newly diagnosed metastatic prostate cancer initially treated with androgen deprivation therapy

A novel prognostic model for Japanese patients with newly diagnosed bone‐metastatic hormone‐naïve prostate cancer

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