Risk factors for progression to castration-resistant prostate cancer in metastatic prostate cancer patients

Ting-Ting Lin^*, Ye-Hui Chen^*, Yu-Peng Wu^*, Shao-Zhan Chen^*, Xiao-Dong Li, Yun-Zhi Lin, Shao-Hao Chen, Qing-Shui Zheng, Yong Wei, Ning Xu^✉, Xue-Yi Xue^✉

Departments of Urology, the First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005, China
*These authors contributed equally to this work.

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Citation:
Lin TT, Chen YH, Wu YP, Chen SZ, Li XD, Lin YZ, Chen SH, Zheng QS, Wei Y, Xu N, Xue XY. Risk factors for progression to castration-resistant prostate cancer in metastatic prostate cancer patients. J Cancer 2019; 10(22):5608-5613. doi:10.7150/jca.30731. Available from https://www.jcancer.org/v10p5608.htm

Abstract

Purpose: To investigate the risk factors for progression to castration-resistant prostate cancer (CRPC) in metastatic prostate cancer (mPCa) patients who underwent androgen deprivation therapy (ADT).

Methods: We analyzed 216 patients with mPCa who underwent ADT between January 2006 and December 2015 at the First Affiliated Hospital of Fujian Medical University. Univariate and multivariate Cox regression analysis were used to explore the risk factors for progression to CRPC. Kaplan-Meier analysis and log-rank test were used to evaluate the difference in progression-free survival (PFS).

Results: A total of 121 (56.0%) patients who underwent ADT showed progression to CRPC. Multivariate Cox regression analysis demonstrated that Gleason grade group, prostate-specific antigen nadir (nPSA), and time to PSA nadir (TTN) were risk factors for progression to CRPC in mPCa patients. Kaplan-Meier analysis demonstrated that patients in Gleason grade group ≥3, nPSA >0.2 ng/ml and TTN <6 months had shorter PFS.

Conclusion: This study demonstrated that Gleason grade group, nPSA and TTN were risk factors for progression to CRPC. Patients with higher Gleason grade group, higher nPSA and shorter TTN have shorter PFS and higher risk of progression to CRPC after ADT.

Keywords: metastatic prostate cancer, androgen deprivation therapy, castration-resistant prostate cancer, progression-free survival, risk factors