We evaluated the impact of early changes in serum biomarker levels on the survival of patients with metastatic hormone-sensitive prostate cancer (mHSPC) who were initially treated with androgen deprivation therapy (ADT). We retrospectively investigated 330 patients with mHSPC whose serum maker levels were at baseline and at 2-4 months. An optimal Cox regression model was established with the highest optimism-corrected concordance index based on 10-fold cross-validation. The median cancer-specific survival (CSS) and overall survival (OS) were 7.08 and 6.47 years (median follow-up, 2.53 years), respectively. In the final optimal Cox model with serum biomarker levels treated as time-varying covariates, prostate-specific antigen (PSA), hemoglobin (Hb), and alkaline phosphatase (ALP) significantly increased the risk of poor survival in the context of both CSS and OS. Kaplan-Meier curves stratified by the three risk factors of high PSA, low Hb and high ALP desmondtated that median OS were not reached with none of these factors, 6.47 years with one or two factors, and 1.76 years with all three factors.Early changes in serum biomarker levels after ADT may be good prognostic markers for the survival of patients with mHSPC.
Scientific reports. 2019 Aug 19*** epublish ***
Shintaro Narita, Kyoko Nomura, Shingo Hatakeyama, Masahiro Takahashi, Toshihiko Sakurai, Sadafumi Kawamura, Senji Hoshi, Masanori Ishida, Toshiaki Kawaguchi, Shigeto Ishidoya, Jiro Shimoda, Hiromi Sato, Koji Mitsuzuka, Tatsuo Tochigi, Norihiko Tsuchiya, Chikara Ohyama, Yoichi Arai, Kengo Nagashima, Tomonori Habuchi
Department of Urology, Akita University School of Medicine, Akita, Japan. ., Department of Environmental Health Science and Public Health, Akita University School of Medicine, Akita, Japan., Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan., Department of Urology, Tohoku University School of Medicine, Sendai, Japan., Department of Urology, Yamagata University School of Medicine, Yamagata, Japan., Department of Urology, Miyagi Cancer Center, Miyagi, Japan., Department of Urology, Yamagata Prefectural Central Hospital, Yamagata, Japan., Department of Urology, Iwate Prefectural Isawa Hospital, Isawa, Japan., Department of Urology, Aomori Prefectural Central Hospital, Aomori, Japan., Department of Urology, Sendai City Hospital, Sendai, Japan., Department of Urology, Akita University School of Medicine, Akita, Japan., Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Azabu, Japan.