Construction and validation of a nomogram for identifying the patients at risk for rapid progression of advanced hormone-sensitive prostate cancer.

Background: This study aimed to evaluate the prognostic significance of lactate dehydrogenase (LDH) and fasting triglyceride-glucose (TyG) index in advanced hormone-sensitive prostate cancer (HSPC) patients, with the ultimate goal of developing and validating a nomogram for predicting castration-resistant prostate cancer (CRPC) free survival.

Materials and methods: The follow-up data of 207 CRPC patients who had androgen deprivation therapy as their initial and only treatment before progression were retrospectively reviewed. To assess prognostic variables, univariate and multivariate Cox regression analyses were performed. The concordance index (C-index), calibration curves, receiver operating characteristic (ROC) curves, and decision curve analyses (DCA) were utilized to construct and test a novel nomogram model.

Results: TyG index, LDH, M stage and Gleason sum were determined to be independent prognostic markers and were combined to create a nomogram. This nomogram worked well in the tailored prediction of CRPC development at the sixth, twelve, eighteen, and twenty-fourth months. The C-indexes for the training and validation sets were 0.798 and 0.790, respectively. The ROC curves, calibration plots, and DCA all indicated good discrimination and prediction performance. Furthermore, the nomogram had a higher prognostic ability than the M stage and the Gleason sum. The nomogram-related risk score classified the patient population into two groups with significant progression differences.

Conclusions: The created nomogram could help identify patients at high risk for rapid progression of advanced HSPC, allowing for the formulation of tailored therapy regimens and follow-up methods in a timely manner.