The prognostic value of nadir PSA level and time to nadir in high risk mHNPC patients

Abstract

Abstract Background The prognosis of patients with high risk metastatic hormone-naive prostate cancer is poor.The present study investigated the prognostic significance in Japanese men with high-risk mHNPC when stratified by the criteria in the LATITUDE trial, and initial experience with upfront abiraterone in high-risk mHNPC Methods The present study retrospectively enrolled 60 men who were considered to be High risk mHNPC, at our institution from 2010 to 2018. Results The median OS was 40 months (95% CI 33.1-49.2 months).The median time to CRPC was 34 months (95% CI 28.7-57.5 months ) in the low-risk mHNPC group and 15 months (95% CI 14.0-25.4 months, P = 0.019) in the high-risk mHNPC group.In the high-risk mHNPC, the median time to CRPC was 36 months (95% CI 5.4-66.5 months ) in the low-PSA nadir group ( PSA nadir was less than 0.2 ng/ml) and 12 months (95% CI 6.8-17.1 months, P = 0.005) in the high-PSA nadir group ( PSA nadir was more than 0.2 ng/ml).The median time to CRPC was 15 months (95% CI 10.8-19.1 months ) in the low-iPSA group ( iPSA was less than 330 ng/ml) and 15 months (95% CI 4.7-25.2 months, P = 0.83) in the high-iPSA group ( PSA nadir was more than 330 ng/ml).Time to nadir is positively associated with time to nadir (P > 0.001 ).Multivariate analysis revealed that longer time to nadir was significant prognostic factor. Conclusion Prognosis of high-risk mHNPC was poor in Japanese population.It revealed that PSA response play an important role in progression of high-risk mHNPC.