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Risk factors analysis for the progression to castration-resistant prostate cancer / 中华泌尿外科杂志
Chinese Journal of Urology ; (12): 847-851, 2018.
Article in Chinese | WPRIM | ID: wpr-709610
ABSTRACT
Objective To explore risk factors of the progression to castration-resistant prostate cancer(CRPC)after hormone therapy (HT).Methods A total of 178 patients with prostate cancer from February 2009 to February 2018 were enrolled to analyze the risk factors of the progression to castrationresistant prostate cancer after androgen deprivation therapy in Fujian Medical University Union Hospital.The mean age was72 years (range,49-91 years);the middle Gleason score was 7 (range,4-10);the middle PSA at the initiation of HT was 24.45 ng/ml (range,0.16-100.0 ng/ml);the middle time to PSA nadir was 9 months (range,0.5-69.0 months);the middle PSA nadir after HT was 0.030 ng/ml (range,0.003-78.670 ng/ml);the mean hemoglobin level was 131 g/L (range,64-184 g/L);the mean alkaline phosphatase level was 98 U/L (range,35-734 U/L);39 patients were diabetes mellitus (21.9%);82 patients were bone metastasis/visceral metastasis (46.1%);85 patients (47.8 %) were in clinical T1 + T2;93 patients(52.2%)were in clinical T3 + T4.We studied the relationship between CRPC and these risk factors including age,Gleason score,PSA at the initiation of HT,PSA nadir after HT,the time to PSA nadir,hemoglobin level,alkaline phosphatase,bone metastasis/visceral metastasis,clinical T stage,diabetes mellitus by x2 test,univariate and multivariate Cox regression analysis methods.Results The middle follow-up time was 30 months (range,6-92 months).There were 74 of 178 patients progressed to CRPC after HT.The median time of progression to CRPC in this cohort was 15 months (range,4-47 months).On x2 test analysis,there were statistically significant differences between the progression to CRPC group after HT and the rest group in Gleason score (P <0.001),PSA nadir after HT (P <0.001),PSA at the initiation of HT (P =0.042),alkaline phosphatase (P =0.002),bone metastasis/visceral metastasis (P<0.001) and clinical T stage (P <0.001).Additionally,on multivariate Cox regression analysis,Gleason score (OR =6.152,P < 0.001),PSA nadir after HT (OR =3.022,P < 0.004) and the time to PSA nadir (OR =0.375,P <0.001) were found to be significantly associated with the rapid progression to CRPC.Conelusions Gleason score,PSA nadir after HT and the time to PSA nadir were significantly associated with the progression to CRPC.Patients with higher PSA nadir or the shorter time to PSA nadir were more likely to progress to CRPC.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Etiology study / Risk factors Language: Chinese Journal: Chinese Journal of Urology Year: 2018 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Etiology study / Risk factors Language: Chinese Journal: Chinese Journal of Urology Year: 2018 Type: Article