Abstract 5537: Prognostic impact of sarcopenia in patients with metastatic castration sensitive prostate cancer

Abstract

Abstract Background/Aim: Recently, sarcopenia has been reported to be a useful prognostic factor in cancer patients, including prostate cancer patients. Gleason score, the presence or absence of visceral metastases, and the number of bone metastases, which were used in the LATITUDE and CHAARTED trials, are known prognostic factors for metastatic castration-sensitive prostate cancer (mCSPC). Although a large proportion of patients with mCSPC are elderly, the significance of sarcopenia in metastatic castration-sensitive prostate cancer is unknown. Patients and Methods: Of 193 patients with mCSPC treated at Kanazawa University Hospital between 2000 and 2019, 150 patients with confirmed CT at diagnosis were included. Sarcopenia was determined based on the definition of Martin et al. Overall survival and prognostic factors were retrospectively evaluated. Results: The median age was 72 years, median PSA 241 ng/mL, Gleason score (GS) ≥ 9 in 91 patients, visceral metastases in 23 patients, and sarcopenia in 106 patients. 109 patients (72.7%) were diagnosed as high risk by Latitude risk classification and 105 patients (70%) were diagnosed as high volume by Charted risk classification. All cause death was 64 patients, and the median follow-up period was 38.2 months. The median overall survival was 69.6 months. On multivariate analysis, GS ≥9 (P <0.0001, hazard risk =3.78), LDH ≥ 300 U/L (P <0.0001, hazard risk =2.88), and sarcopenia (P=0.04, hazard risk=2.07) were significant independent poor prognostic factors predicting shorter OS. The prognosis could be significantly stratified into a high risk group if two or more of these three factors were met and a low risk group if one or less was met (44 months vs. 106.4 months, P=0.0001, hazard risk=2.91). This classification more clearly stratified prognosis than the LATITUD classification (55.1 months vs. 135 months, P =0.027, hazard risk =1.8) or the CHAARTED trial classification (52.9 months vs. 135 months, P =0.009, hazard risk =1.98). Conclusion: Sarcopenia that can assess general status was considered useful in the prognostic evaluation of patients with mCSPC. Citation Format: Hiroaki Iwamoto, Kouji Izumi, Atsushi Mizokami. Prognostic impact of sarcopenia in patients with metastatic castration sensitive prostate cancer. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5537.