Abstract
PurposeThe aim of our retrospective study was to determine the time to progression to castration-resistant prostate cancer (CRPC) in prostate cancer patients who undergo combined androgen blockade (CAB), as well as their prognoses.Materials and MethodsWe examined the overall survival (OS) and disease-specific survival rates, as well as the time to CRPC development, in 387 patients who were treated with CAB for prostate cancer. The disease-specific survival rate and time to CRPC were stratified by prostate-specific antigen (PSA) levels, Gleason score (GS), and presence of metastasis at diagnosis. We designated high-risk patients as those satisfying at least two of the following three criteria: extent of disease of bone metastasis grade ≥2, presence of metastasis at diagnosis, and a GS ≥8.ResultsThe 10- and 15-year OS rates were 74.0% and 50.4%, respectively, while the corresponding disease-specific survival rates were both 86.8%. Metastasis at diagnosis was an independent prognostic factor for disease-specific survival. The median time to CRPC development was 140.7 months. A PSA level ≥20 ng/mL, a GS ≥8, and the presence of metastasis at diagnosis were independent predictors of a shorter time to CRPC development. The 10-year disease-specific survival rate in the high-risk group was significantly lower than that in the low-risk group (approximately 74% vs. 98%), and the time to CRPC development was significantly shorter (median: 20.5 months vs. not reached).ConclusionsThe time to CRPC development was shorter in high-risk prostate cancer patients with metastases. Such patients require alternative novel treatment modalities.
Highlights
Since Huggins first reported that surgical castration is an effective treatment for advanced prostate cancer [1], hormonal therapy has become an established intervention for previously untreated patients with this disease
The time to castration-resistant prostate cancer (CRPC) development was shorter in high-risk prostate cancer patients with metastases
combined androgen blockade (CAB) was not found to be superior to androgen deprivation therapy (ADT) monotherapy in Western countries [3]; controlled trials in Japan found that CAB led www.oncotarget.com to significantly longer overall survival (OS) than ADT monotherapy in patients with stages C and D1 disease, not in those with stage D2 disease [4, 5]
Summary
Since Huggins first reported that surgical castration is an effective treatment for advanced prostate cancer [1], hormonal therapy has become an established intervention for previously untreated patients with this disease. OS following ADT monotherapy was 24 months among patients with prostate cancer who had bone metastasis at initial diagnosis and 16 months among those who had visceral metastasis; the median OS of those who had both types of metastasis was 14 months [8]. Some studies showed that docetaxel or abiraterone in combination with initial hormonal therapy was more effective for high-risk prostate cancer patients than ADT monotherapy [9,10,11,12]. In these studies, ADT monotherapy was used in all the control groups, whereas in Japan, CAB is often used as the initial hormonal therapy. It remains unclear whether ADT combined with docetaxel or abiraterone is beneficial for Japanese patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
