Predicting factors for progression to castration resistance prostate cancer after biochemical recurrence in patients wit
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ORIGINAL ARTICLE
Predicting factors for progression to castration resistance prostate cancer after biochemical recurrence in patients with clinically localized prostate cancer who underwent radical prostatectomy Takeshi Hashimoto1 · Jun Nakashima2,3 · Takeshi Kashima1 · Yuri Yamaguchi1 · Naoya Satake1 · Yoshihiro Nakagami1 · Kazunori Namiki1 · Yoshio Ohno1 Received: 10 April 2020 / Accepted: 25 May 2020 © Japan Society of Clinical Oncology 2020
Abstract Background To determine prognostic factors associated with progression to castration-resistant prostate cancer following biochemical recurrence which is lethal prostate cancer and establish a risk stratification model of progression to castrationresistant prostate cancer. Methods We retrospectively reviewed the data of 550 patients who experienced biochemical recurrence after radical prostatectomy. The endpoint of the present study was progression to castration-resistant prostate cancer. The actuarial probabilities of progression to castration-resistant prostate cancer-free survival were determined using Kaplan–Meier analysis. Univariate and multivariate Cox proportional hazards regression analyses were used to identify independent predictors of biochemical recurrence. Results Fifty-two patients experienced progression to castration-resistant prostate cancer during the follow-up period. The progression to castration-resistant prostate cancer-free survival rate after biochemical recurrence at 10 years was 76.8%. In multivariate analysis, pathological Gleason score ≥ 9, lymphovascular invasion, and prostate-specific antigen velocity ≥ 0.4 ng/mL/year were independent predictive factors for progression to castration-resistant prostate cancer. The patients were stratified into three groups using a risk stratification model incorporating these variables. The 10-year progression to castration-resistant prostate cancer-free survival rates were 96.7% in the low-risk group, 84.7% in the intermediate-risk group, and 24.5% in the high-risk group. Conclusions The present results suggest that the pathological Gleason score, lymphovascular invasion, and prostate-specific antigen velocity were independent predictive factors for progression to castration-resistant prostate cancer. The risk stratification model established in the present study could be useful for patient counseling and in identifying patients with a poor prognosis. Keywords Radical prostatectomy · Biochemical recurrence · Castration-resistant prostate cancer · Risk stratification model
* Takeshi Hashimoto ha‑tkc@tokyo‑med.ac.jp
Kazunori Namiki k‑namiki@tokyo‑med.ac.jp
Jun Nakashima [email protected]
Yoshio Ohno yoshio‑o@tokyo‑med.ac.jp
Takeshi Kashima [email protected]
1
Yuri Yamaguchi [email protected]
Department of Urology, Tokyo Medical University, 6‑7‑1 Nishi‑shinjuku, Shinjuku‑ku, Tokyo 160‑0023, Japan
2
Department of Urology, Sanno Hospital, Tokyo, Japan
3
Clinical Medicine Research Center, International University of Health and Welfare, Tokyo, Japan
Naoya S
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