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Abstract
A multicenter study of nonmetastatic castration-resistant prostate cancer (nmCRPC) was conducted to identify the optimal cut-off value of prostate-specific antigen (PSA) doubling time (PSADT) that correlated with the prognosis in Japanese nmCRPC. Of the 515 patients diagnosed and treated for nmCRPC at 25 participating Japanese Urological Oncology Group centers, 450 patients with complete clinical information were included. The prognostic values of clinical factors were evaluated with respect to prostate specific antigen progression-free (PFS), cancer-specific survival (CSS), and overall survival (OS). The optimal cutoff value of PSADT was identified using survival tree analysis by Python. The Median PSA and PSADT at diagnosis of nmCRPC were 3.3 ng/ml, and 5.2 months, respectively. Patients treated with novel hormonal therapy (NHT) showed significantly longer PFS (HR: hazard ratio 0.38, p < 0.0001) and PFS2 (HR 0.45, p < 0.0001) than those treated with vintage nonsteroidal antiandrogen agent (Vintage). The survival tree identified 4.65 months as the most prognostic PSADT cutoff point. Among the clinical and pathological factors PSADT of < 4.65 months remained an independent prognostic factor for OS (HR 2.96, p = 0.0003) and CSS (HR 3.66, p < 0.0001). Current data represented optimal cut-off of PSADT 4.65 months for a Japanese nmCRPC.
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1 Chiba University Graduate School of Medicine, Department of Urology, Chiba, Japan (GRID:grid.136304.3) (ISNI:0000 0004 0370 1101)
2 The Jikei University School of Medicine, Department of Urology, Tokyo, Japan (GRID:grid.411898.d) (ISNI:0000 0001 0661 2073)
3 National Cancer Center Japan, Department of Urology, Tokyo, Japan (GRID:grid.272242.3) (ISNI:0000 0001 2168 5385)
4 Shizuoka General Hospital, Department of Urology, Shizuoka, Japan (GRID:grid.415804.c) (ISNI:0000 0004 1763 9927)
5 Sapporo Medical University School of Medicine, Department of Urology, Sapporo, Japan (GRID:grid.263171.0) (ISNI:0000 0001 0691 0855)
6 Kobe University Graduate School of Medicine, Division of Urology, Department of Surgery Related, Kobe, Japan (GRID:grid.31432.37) (ISNI:0000 0001 1092 3077)
7 Akita University Graduate School of Medicine, Department of Urology, Akita, Japan (GRID:grid.251924.9) (ISNI:0000 0001 0725 8504)
8 The Jikei University School of Medicine, Kashiwa Hospital, Department of Urology, Kashiwa, Japan (GRID:grid.411898.d) (ISNI:0000 0001 0661 2073)
9 Hokkaido University Faculty of Medicine, Department of Urology, Sapporo, Japan (GRID:grid.39158.36) (ISNI:0000 0001 2173 7691)
10 Kagawa University, Department of Urology, Faculty of Medicine, Takamatsu, Japan (GRID:grid.258331.e) (ISNI:0000 0000 8662 309X)
11 Niigata Cancer Center Hospital, Department of Urology, Niigata, Japan (GRID:grid.416203.2) (ISNI:0000 0004 0377 8969)
12 National Hospital Organization Shikoku Cancer Center, Department of Urology, Matsuyama, Japan (GRID:grid.415740.3) (ISNI:0000 0004 0618 8403)
13 Kyushu University, Department of Urology, Graduate School of Medical Sciences, Fukuoka, Japan (GRID:grid.177174.3) (ISNI:0000 0001 2242 4849)
14 Ibaraki Prefectural Central Hospital, Ibaraki Cancer Center, Department of Urology, Kasama, Japan (GRID:grid.414493.f) (ISNI:0000 0004 0377 4271)
15 University of Fukui, Department of Urology, Fukui, Japan (GRID:grid.163577.1) (ISNI:0000 0001 0692 8246)
16 Kurume University School of Medicine, Department of Urology, Kurume, Japan (GRID:grid.410781.b) (ISNI:0000 0001 0706 0776)
17 Teikyo University School of Medicine, Department of Urology, Tokyo, Japan (GRID:grid.264706.1) (ISNI:0000 0000 9239 9995)
18 Kagoshima University, Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima, Japan (GRID:grid.258333.c) (ISNI:0000 0001 1167 1801)
19 Mie University Graduate School of Medicine, Department of Nephro-Urologic Surgery and Andrology, Tsu, Japan (GRID:grid.260026.0) (ISNI:0000 0004 0372 555X)
20 University of Tsukuba, Department of Urology, Tsukuba, Japan (GRID:grid.20515.33) (ISNI:0000 0001 2369 4728)
21 University of Toyama, Department of Urology, Faculty of Medicine, Toyama, Japan (GRID:grid.267346.2) (ISNI:0000 0001 2171 836X)
22 Chiba University, Department of Artificial Intelligence Medicine, Graduate School of Medicine, Chiba, Japan (GRID:grid.136304.3) (ISNI:0000 0004 0370 1101)