Department of Urology, Baoji Central Hospital, #8 Jiangtan Road, Baoji, 721008, Shaanxi Province, People's Republic of China.
Sci Rep. 2024 Nov 4;14(1):26712. doi: 10.1038/s41598-024-78592-z.
The prognostic value of prostate-specific antigen (PSA) kinetics in primary high-volume metastatic hormone-sensitive prostate cancer (mHSPC) patients treated with novel hormonal therapy agents is still unclear. Here, we retrospectively reviewed the data of 102 patients with primary high-volume mHSPC who received novel hormonal therapy agents. The median follow-up was 32.25 ± 14.51 months and the median nadir PSA (nPSA) was 0.20 (0.06, 11.71) ng/mL after treatment. The mean time to nPSA was 10.82 ± 7.27 months and 55 patients (53.9%) had a PSA-density (PSA-D) ≤ 0.08 at 3-months. Univariate and multivariate Cox regression analyses showed that the absence of visceral metastases, nPSA ≤ 0.2 and PSA-D ≤ 0.08 were independent prognostic factors for better PFS and OS (all P < 0.05). Moreover, patients with nPSA ≤ 0.2 and PSA-D ≤ 0.08 had the best PFS and OS, and the combination of the nPSA and PSA-D had a better predictive accuracy for PFS and OS than nPSA and PSA-D alone. Thus, Visceral metastases, nPSA and PSA-D were independent prognostic factors for primary high-volume mHSPC patients treated with novel hormonal therapy agents. Patients with lower nPSA and PSA-D had a best survival outcome, and the combination of nPSA and PSA-D had a better effect on prognosis predicting.
在接受新型激素治疗药物治疗的原发性高容量转移性激素敏感前列腺癌（mHSPC）患者中，前列腺特异性抗原（PSA）动力学的预后价值尚不清楚。在这里，我们回顾性分析了 102 例接受新型激素治疗药物治疗的原发性高容量 mHSPC 患者的数据。中位随访时间为 32.25±14.51 个月，治疗后中位最低 PSA（nPSA）为 0.20（0.06，11.71）ng/mL。nPSA 达到时间的平均值为 10.82±7.27 个月，55 例（53.9%）患者在 3 个月时 PSA 密度（PSA-D）≤0.08。单因素和多因素 Cox 回归分析表明，无内脏转移、nPSA≤0.2 和 PSA-D≤0.08 是无进展生存期和总生存期较好的独立预后因素（均 P<0.05）。此外，nPSA≤0.2 和 PSA-D≤0.08 的患者具有最佳的无进展生存期和总生存期，并且 nPSA 和 PSA-D 的组合对无进展生存期和总生存期的预测准确性优于 nPSA 和 PSA-D 单独。因此，内脏转移、nPSA 和 PSA-D 是接受新型激素治疗药物治疗的原发性高容量 mHSPC 患者的独立预后因素。nPSA 和 PSA-D 较低的患者具有最佳的生存结局，nPSA 和 PSA-D 的组合对预后预测具有更好的效果。
