Predictive Factor to Castrate-Resistant Prostate Cancer (CRPC) after Primary Androgen Deprivation Therapy (ADT): Single Center Experience in Indonesia

Abstract

ADT is the main therapy in prostate cancer, especially in advanced stages, although ADT does not limit the progression of this disease to become CRPC, where the mortality rate will be much higher when CRPC has occurred. This study aims to examine corellating factors influenced the short duration to CRPC after primary ADT administration. 205 prostate cancer patients with CRPC or mCRPC in Saiful Anwar Malang Hospital from 2013 to 2018 were included in this study. Data recorded were age, initial PSA level, Gleason score, prostate cancer stage, type of ADT, nadir PSA, time between ADT and nadir PSA, and testosterone levels after ADT. To see the independent factors that influence the occurrence of CRPC, the Cox proportional hazards regression model was used. The average age of patients was 67, 53  6.86 years with an average level of initial PSA of 674.87  1405.80 80 / dL. The average time for CRPC to occur was 24.7  9.74 months. In multivariate analysis it was found that the stage of cancer with metastasis (HR 1,616, p 0,048), testosterone level after ADT was > 20ng / dL (HR 4,638, p 0,000), nadir PSA > 4ng / dL (HR 1,716, p 0,023) and time to reach Nadir PSA <6 months (HR 1.596, p 0.004) is a significant independent factor for CRPC occurrence. The conclusion is cancer stage, testosterone levels after ADT, nadir PSA and time needed to reach nadir PSA were independent factors for CRPC in patients with prostate cancer who had primary ADT.