Clinical significance of primary tumor progression in metastatic hormone-sensitive prostate cancer
Background: Clinical significance of primary tumor progression in patients with metastatic hormone-sensitive prostate cancer (mHSPC) is unclear. Methods: Clinical data from 987 patients with mHSPC from multiple institutions between September 1999 and November 2023 were reviewed. The prognostic impac...
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Elsevier
2025-03-01
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| Series: | Prostate International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2287888224000874 |
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| author | Yasutaka Yamada Shinichi Sakamoto Takuya Tsujino Sinpei Saito Kodai Sato Kazuki Nishimura Tatsuo Fukushima Ko Nakamura Yuki Yoshikawa Tomohisa Matsunaga Ryoichi Maenosono Manato Kanesaka Takayuki Arai Tomokazu Sazuka Yusuke Imamura Kazumasa Komura Kazuo Mikami Kazuyoshi Nakamura Satoshi Fukasawa Kazuto Chiba Yukio Naya Maki Nagata Atsushi Komaru Hiroomi Nakatsu Haruhito Azuma Tomohiko Ichikawa |
| author_facet | Yasutaka Yamada Shinichi Sakamoto Takuya Tsujino Sinpei Saito Kodai Sato Kazuki Nishimura Tatsuo Fukushima Ko Nakamura Yuki Yoshikawa Tomohisa Matsunaga Ryoichi Maenosono Manato Kanesaka Takayuki Arai Tomokazu Sazuka Yusuke Imamura Kazumasa Komura Kazuo Mikami Kazuyoshi Nakamura Satoshi Fukasawa Kazuto Chiba Yukio Naya Maki Nagata Atsushi Komaru Hiroomi Nakatsu Haruhito Azuma Tomohiko Ichikawa |
| author_sort | Yasutaka Yamada |
| collection | DOAJ |
| description | Background: Clinical significance of primary tumor progression in patients with metastatic hormone-sensitive prostate cancer (mHSPC) is unclear. Methods: Clinical data from 987 patients with mHSPC from multiple institutions between September 1999 and November 2023 were reviewed. The prognostic impact of primary tumor progression was examined along with other clinical parameters. Castration-resistant prostate cancer progression-free survival (CRPC PFS) and overall survival (OS) were analyzed as clinical outcomes. Student's t-test, Cox proportional hazards models, and Kaplan-Meier methods were utilized to validate the clinical significance. Results: The median age and initial prostate-specific antigen (iPSA) values were 74 and 221 ng/ml, respectively. 632 (64%) and 355 (36%) patients had clinical T stage ≤3 and 4 at diagnosis, respectively. mHSPC patients with clinical T stage 4 were more likely to have a higher grade group (GG), higher frequency of lymph node metastasis, lower hemoglobin (Hb), and more high-volume/risk disease in comparison with those with clinical T stage ≤3. Patients with cT4 were associated with shorter CRPC PFS (P=0.0002) and OS (P < 0.0001). Multivariate analysis identified cT4 as an independent prognostic factor for OS (HR=1.33, P=0.03) along with age, GG, lactate dehydrogenase (LDH), alkaline phosphatase (ALP), albumin (Alb), and high-volume disease. After propensity score matching, patients with cT4 had unfavorable OS in comparison with those with ≤cT3 (P=0.0279). Furthermore, when combined with tumor volume, men with low-volume + cT4 achieved a prognosis comparable to that of patients with high-volume+≤cT3 and high-volume + cT4 (P=0.6876 and P=0.1679, respectively). Conclusion: Bulkiness of primary prostate tumor was associated with worse outcomes in patients with mHSPC. Men with cT4 will require multimodal and intensive therapeutic strategies irrespective of tumor volume. |
| format | Article |
| id | doaj-art-fd07abb1afca4061b42784587e51ed39 |
| institution | Kabale University |
| issn | 2287-8882 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Prostate International |
| spelling | doaj-art-fd07abb1afca4061b42784587e51ed392025-08-20T03:44:17ZengElsevierProstate International2287-88822025-03-01131606610.1016/j.prnil.2024.11.005Clinical significance of primary tumor progression in metastatic hormone-sensitive prostate cancerYasutaka Yamada0Shinichi Sakamoto1Takuya Tsujino2Sinpei Saito3Kodai Sato4Kazuki Nishimura5Tatsuo Fukushima6Ko Nakamura7Yuki Yoshikawa8Tomohisa Matsunaga9Ryoichi Maenosono10Manato Kanesaka11Takayuki Arai12Tomokazu Sazuka13Yusuke Imamura14Kazumasa Komura15Kazuo Mikami16Kazuyoshi Nakamura17Satoshi Fukasawa18Kazuto Chiba19Yukio Naya20Maki Nagata21Atsushi Komaru22Hiroomi Nakatsu23Haruhito Azuma24Tomohiko Ichikawa25Department of Urology, Chiba University Graduate School of Medicine, Chiba, JapanDepartment of Urology, Chiba University Graduate School of Medicine, Chiba, Japan; Corresponding author. Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 2608670, Japan.Department of Urology, Osaka Medical and Pharmaceutical University, Osaka, JapanDepartment of Urology, Chiba University Graduate School of Medicine, Chiba, JapanDepartment of Urology, Chiba University Graduate School of Medicine, Chiba, JapanDepartment of Urology, Osaka Medical and Pharmaceutical University, Osaka, JapanDepartment of Urology, Osaka Medical and Pharmaceutical University, Osaka, JapanDepartment of Urology, Osaka Medical and Pharmaceutical University, Osaka, JapanDepartment of Urology, Osaka Medical and Pharmaceutical University, Osaka, JapanDepartment of Urology, Osaka Medical and Pharmaceutical University, Osaka, JapanDepartment of Urology, Osaka Medical and Pharmaceutical University, Osaka, JapanDepartment of Urology, Chiba University Graduate School of Medicine, Chiba, JapanDepartment of Urology, Chiba University Graduate School of Medicine, Chiba, JapanDepartment of Urology, Chiba University Graduate School of Medicine, Chiba, JapanDepartment of Urology, Chiba University Graduate School of Medicine, Chiba, JapanDepartment of Urology, Osaka Medical and Pharmaceutical University, Osaka, JapanDepartment of Urology, Chibaken Saiseikai Narashino Hospital, Chiba, JapanDepartment of Urology, Kimitsu Chuo Hospital, Chiba, JapanDepartment of Urology, Funabashi Municipal Medical Center, Chiba, JapanDepartment of Urology, Fukaya Red Cross Hospital, Saitama, JapanDepartment of Urology, Teikyo University Chiba Medical Center, Chiba, JapanDepartment of Urology, Yokohama Rosai Hospital, Kanagawa, JapanProstate Center and Division of Urology, Chiba Cancer Center, Chiba, JapanDepartment of Urology, Asahi General Hospital, Chiba, JapanDepartment of Urology, Osaka Medical and Pharmaceutical University, Osaka, JapanDepartment of Urology, Chiba University Graduate School of Medicine, Chiba, JapanBackground: Clinical significance of primary tumor progression in patients with metastatic hormone-sensitive prostate cancer (mHSPC) is unclear. Methods: Clinical data from 987 patients with mHSPC from multiple institutions between September 1999 and November 2023 were reviewed. The prognostic impact of primary tumor progression was examined along with other clinical parameters. Castration-resistant prostate cancer progression-free survival (CRPC PFS) and overall survival (OS) were analyzed as clinical outcomes. Student's t-test, Cox proportional hazards models, and Kaplan-Meier methods were utilized to validate the clinical significance. Results: The median age and initial prostate-specific antigen (iPSA) values were 74 and 221 ng/ml, respectively. 632 (64%) and 355 (36%) patients had clinical T stage ≤3 and 4 at diagnosis, respectively. mHSPC patients with clinical T stage 4 were more likely to have a higher grade group (GG), higher frequency of lymph node metastasis, lower hemoglobin (Hb), and more high-volume/risk disease in comparison with those with clinical T stage ≤3. Patients with cT4 were associated with shorter CRPC PFS (P=0.0002) and OS (P < 0.0001). Multivariate analysis identified cT4 as an independent prognostic factor for OS (HR=1.33, P=0.03) along with age, GG, lactate dehydrogenase (LDH), alkaline phosphatase (ALP), albumin (Alb), and high-volume disease. After propensity score matching, patients with cT4 had unfavorable OS in comparison with those with ≤cT3 (P=0.0279). Furthermore, when combined with tumor volume, men with low-volume + cT4 achieved a prognosis comparable to that of patients with high-volume+≤cT3 and high-volume + cT4 (P=0.6876 and P=0.1679, respectively). Conclusion: Bulkiness of primary prostate tumor was associated with worse outcomes in patients with mHSPC. Men with cT4 will require multimodal and intensive therapeutic strategies irrespective of tumor volume.http://www.sciencedirect.com/science/article/pii/S2287888224000874Androgen deprivation therapyClinical T stage 4Metastatic hormone-sensitive prostate cancerPrimary tumorTumor volume |
| spellingShingle | Yasutaka Yamada Shinichi Sakamoto Takuya Tsujino Sinpei Saito Kodai Sato Kazuki Nishimura Tatsuo Fukushima Ko Nakamura Yuki Yoshikawa Tomohisa Matsunaga Ryoichi Maenosono Manato Kanesaka Takayuki Arai Tomokazu Sazuka Yusuke Imamura Kazumasa Komura Kazuo Mikami Kazuyoshi Nakamura Satoshi Fukasawa Kazuto Chiba Yukio Naya Maki Nagata Atsushi Komaru Hiroomi Nakatsu Haruhito Azuma Tomohiko Ichikawa Clinical significance of primary tumor progression in metastatic hormone-sensitive prostate cancer Prostate International Androgen deprivation therapy Clinical T stage 4 Metastatic hormone-sensitive prostate cancer Primary tumor Tumor volume |
| title | Clinical significance of primary tumor progression in metastatic hormone-sensitive prostate cancer |
| title_full | Clinical significance of primary tumor progression in metastatic hormone-sensitive prostate cancer |
| title_fullStr | Clinical significance of primary tumor progression in metastatic hormone-sensitive prostate cancer |
| title_full_unstemmed | Clinical significance of primary tumor progression in metastatic hormone-sensitive prostate cancer |
| title_short | Clinical significance of primary tumor progression in metastatic hormone-sensitive prostate cancer |
| title_sort | clinical significance of primary tumor progression in metastatic hormone sensitive prostate cancer |
| topic | Androgen deprivation therapy Clinical T stage 4 Metastatic hormone-sensitive prostate cancer Primary tumor Tumor volume |
| url | http://www.sciencedirect.com/science/article/pii/S2287888224000874 |
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