Prognostic and predictive clinical factors for progression to castration refractory prostate cancer in patients with hormone sensitive prostate can...

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Prostate Cancer
Presenter Masahito Watanabe
Citation Annals of Oncology (2018) 29 (suppl_9): ix67-ix73. 10.1093/annonc/mdy434
Authors M. Watanabe1, K. Kanao1, M. Sugie2, S. Morinaga2, H. Muramatsu2, I. Kobayashi2, K. Kajikawa2, G. Nishikawa2, K. Zennami2, K. Nakamura2, M. Sumitomo2
  • 1Urology, Aichi Medical University, 480-1195 - Nagakute/JP
  • 2Urology, Aichi Medical University, 464-0015 - Nagakute/JP

Abstract

Background

Several studies have reported that abiraterone and docetaxel showed a survival advantage in patients not only with castration refractory prostate cancer (CRPC) but also with high risk hormone sensitive prostate cancer (HSPC). However, the prognostic factors in HSPC are still unclear. The purpose of this study was to evaluate impact of clinical factors before initial therapy on progression to CRPC.

Methods

A total of 107 patients who underwent androgen deprivation therapy and progressed to CRPC at our institution were retrospectively analyzed. Patient’s age, Gleason score, leukocytes, hemoglobin, serum lactate dehydrogenase, alkaline phosphatase, total protein, albumin, C-reactive protein, prostate specific antigen, presence of visceral metastasis and presence of multiple bone metastasis at diagnosis of prostate cancer were estimated as prognostic factor for progression to CRPC. Clinical factors were analyzed by univariable and multivariable Cox proportional hazards and logistic regression analysis to identify independent predictors of prognosis.

Results

The median (95% confidence interval) progression free survival was 37.5 (20.0 - 46.3) months. On multivariable analysis, lower serum albumin level (<4 g/dl) and presence of multiple bone metastasis (≥3 lesions) were associated with shorter progression free survival (HR 2.199, 95% CI [1.276 -3.791]; p < 0.001, HR 2.944, 95% CI [1.724 - 5.027]; p < 0.001). No other factors were independently associated with time to progression to CRPC.

Conclusions

Lower serum albumin level and presence of multiple bone metastasis are strong prognostic factors for progression free survival in patients with HSPC. Our data might suggest that HSPC patients with malnutrition or multiple bone metastases must consider upfront abiraterone or docetaxel.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Department of Urology, Aichi Medical University, School of Medicine.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.