Choi Se Young, Ryu Jeman, You Dalsan, Hong Jun Hyuk, Ahn Hanjong, Kim Choung-Soo
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Int J Urol. 2019 Jan;26(1):62-68. doi: 10.1111/iju.13800. Epub 2018 Sep 20.
To investigate the progression to castration-resistant prostate cancer after primary androgen deprivation therapy, and to build a simple risk prediction model for primary androgen deprivation therapy patients based on the Japan Cancer of the Prostate Risk Assessment criteria.
A total of 602 patients who received primary androgen deprivation therapy were entered into the Korean Cancer Study of the Prostate database. The effect of prognostic factors was determined by multivariate analysis. For each patient, the weight of all factors was totaled to give Korean Cancer Study-prostate scores; patients were divided into three risk groups according to their score. The probability of castration-resistant prostate cancer, cancer-specific survival and overall survival was estimated by Kaplan-Meier analysis.
On multivariate analysis for castration-resistant prostate cancer, the significant variables were initial prostate-specific antigen (>40 ng/mL; 1 point), biopsy Gleason score (≥9; 1 point), clinical N1 (1 point), and non-regional lymph node (1 point), bone (1 point) and visceral (1 point) metastasis. The Korean Cancer Study-prostate scoring model was calculated on a scale of 0-6 (0: low, 1-2: intermediate, ≥3: high risk). The risk groups stratified castration-resistant prostate cancer (P < 0.0001), cancer-specific survival (P < 0.0001) and overall survival (P < 0.0001) by Kaplan-Meier curve. The Korean Cancer Study-prostate model predicted castration-resistant prostate cancer with a c-index of 0.7242, cancer-specific survival with a c-index of 0.7036 and overall survival with a c-index of 0.5890. The 5-year estimated castration-resistant prostate cancer/cancer-specific death rates were 10.3%/6.3% in the low-risk group, 48.4%/22.2% in the intermediate-risk group and 81.7%/53.1% in the high-risk group.
The Korean Cancer Study-prostate risk classification, a modified Japan Cancer of the Prostate Risk Assessment model, is a simple scoring model for predicting oncological outcomes after primary androgen deprivation therapy.
研究初次雄激素剥夺治疗后去势抵抗性前列腺癌的进展情况，并基于日本前列腺癌风险评估标准为接受初次雄激素剥夺治疗的患者建立一个简单的风险预测模型。
共有602例接受初次雄激素剥夺治疗的患者被纳入韩国前列腺癌研究数据库。通过多因素分析确定预后因素的作用。对于每位患者，将所有因素的权重相加得出韩国前列腺癌研究评分；患者根据评分分为三个风险组。采用Kaplan-Meier分析估计去势抵抗性前列腺癌、癌症特异性生存和总生存的概率。
在对去势抵抗性前列腺癌的多因素分析中，显著变量为初始前列腺特异性抗原（>40 ng/mL；1分）、活检Gleason评分（≥9；1分）、临床N1（1分）以及非区域淋巴结转移（1分）、骨转移（1分）和内脏转移（1分）。韩国前列腺癌研究评分模型的计算范围为0至6分（0分：低风险，1 - 2分：中风险，≥3分：高风险）。风险组通过Kaplan-Meier曲线对去势抵抗性前列腺癌（P < 0.0001）、癌症特异性生存（P < 0.0001）和总生存（P < 0.0001）进行了分层。韩国前列腺癌研究模型预测去势抵抗性前列腺癌的c指数为0.7242，癌症特异性生存的c指数为0.7036，总生存的c指数为0.5890。低风险组5年估计的去势抵抗性前列腺癌/癌症特异性死亡率分别为10.3%/6.3%，中风险组为48.4%/22.2%，高风险组为81.7%/53.1%。
韩国前列腺癌研究风险分类，即改良的日本前列腺癌风险评估模型，是一种用于预测初次雄激素剥夺治疗后肿瘤学结局的简单评分模型。
