在雄激素受体信号抑制剂作用下，初始前列腺特异性抗原对转移性激素敏感前列腺癌患者广泛骨转移的预后影响。

IF 2.5 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Prostate Pub Date : 2025-10-01 Epub Date: 2025-07-27 DOI:10.1002/pros.70017

Saizo Fujimoto, Tsuyoshi Morita, Yutaka Yamamoto, Masanobu Saruta, Atsuhiko Yoshizawa, Kiyoshi Takahara, Takuya Tsujino, Ryoichi Maenosono, Yuki Yoshikawa, Wataru Fukuokaya, Takafumi Yanagisawa, Takahiro Kimura, Takeshi Hashimoto, Yosuke Hirasawa, Yoshio Ohno, Kazutoshi Fujita

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引用次数: 0

摘要

目的：我们评估高危转移性激素敏感性前列腺癌（mHSPC）和广泛骨转移患者接受雄激素受体信号抑制剂（ARSI）治疗时初始前列腺特异性抗原（iPSA）水平与预后的关系。对象和方法：本回顾性研究纳入276例接受ARSI作为一线治疗的广泛骨转移（疾病程度[EOD]评分≥2）的新发高危mHSPC患者。这些数据是从参加ULTRA日本研究小组的机构中收集的。患者资料从ULTRAJ组所属机构收集。根据iPSA水平将患者分为四分位数，亚组分析采用临界值200 ng/mL。采用Kaplan-Meier曲线和Cox比例风险回归模型分析总生存期（OS）和无进展生存期（PFS）。利用限制三次样条分析来评价iPSA水平与OS之间的非线性关系。结果：Kaplan-Meier分析显示iPSA四分位数与OS之间存在显著相关性（p = 0.030），最低iPSA组的生存率最低(Q1：结论：初始PSA水平与具有广泛骨转移的高危mHSPC的预后相关。虽然iPSA相对较低的患者OS明显较短，但PFS无显著差异，提示低iPSA患者可以从ARSI作为一线治疗中获益。

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Prognostic Impact of Initial Prostate-Specific Antigen in Metastatic Hormone-Sensitive Prostate Cancer Patients With Extensive Bone Metastases Under Androgen Receptor Signaling Inhibitor.

Objectives: We evaluated the association between initial prostate-specific antigen (iPSA) levels and prognosis in patients with high-risk metastatic hormone-sensitive prostate cancer (mHSPC) and extensive bone metastases treated with androgen receptor signaling inhibitors (ARSI).

Subjects and methods: This retrospective study included 276 de novo high-risk mHSPC patients with extensive bone metastases (extent of disease [EOD] score ≥ 2) who received ARSI as first-line therapy. The data were collected from institutions participating in the ULTRA Japan Study group. Patient data were collected from institutions affiliated with the ULTRAJ group. Patients were stratified into quartiles based on iPSA levels, and a cutoff value of 200 ng/mL was used for subgroup analysis. Overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan-Meier curves and Cox proportional hazards regression models. A restricted cubic spline analysis was conducted to evaluate the nonlinear association between iPSA levels and OS.

Results: Kaplan-Meier analysis demonstrated significant associations between iPSA quartiles and OS (p = 0.030), with the lowest survival observed in the lowest iPSA group (Q1: < 200 ng/mL). A spline-based analysis suggested an inverted J-shaped association between iPSA and OS, with the lowest hazard ratio observed at 1664 ng/mL. Patients with iPSA < 200 ng/mL exhibited significantly shorter OS than those with higher levels (p = 0.015), while no significant difference in PFS was observed (p = 0.869).

Conclusions: Initial PSA levels were associated with prognosis in high-risk mHSPC with extensive bone metastases. Although patients with relatively low iPSA had significantly shorter OS, those exhibited no significant difference in PFS, suggesting that patients with low iPSA could benefit from ARSI as the 1st line treatment.

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来源期刊

Prostate 医学-泌尿学与肾脏学

CiteScore

5.10

自引率

3.60%

发文量

180

审稿时长

1.5 months

期刊介绍： The Prostate is a peer-reviewed journal dedicated to original studies of this organ and the male accessory glands. It serves as an international medium for these studies, presenting comprehensive coverage of clinical, anatomic, embryologic, physiologic, endocrinologic, and biochemical studies.