A Novel Nomogram for Identifying the Patients at Risk for Rapid Progression of Advanced Hormone-Sensitive Prostate Cancer

Overview

Journal Cancer Manag Res

Publisher Dove Medical Press

Specialty Oncology

Date 2023 Sep 25

PMID 37746314

Authors

Mingshuang Wu

Chenxi Pan

Yi He

Bo Yang

Affiliations

Soon will be listed here.

Abstract

Purpose: The goal of this study was to assess the prognostic impact of the lower urinary tract symptoms (LUTS) in advanced prostate cancer (PCa) patients before progression to castration-resistant prostate cancer (CRPC).

Methods: A retrospective analysis of the follow-up data for 152 CRPC patients was performed. Severe LUTS symptom was defined as an International Prostate Symptoms Score (IPSS) ≥20 at baseline. Cox regression analysis was conducted to assess CRPC prognostic factors. Nomogram model was created and assessed using the concordance index (C-index), calibration curves, receiver operating characteristic (ROC) curves, and decision curve analyses (DCA).

Results: The median CRPC free survival of patients with severe LUTS was 20.5 months, significantly longer than that (7.5 months) of less symptomatic patients. Furthermore, severe LUTS, the hemoglobin, albumin, lymphocyte, and platelet (HALP) score, and Gleason sum were determined to be independent prognostic markers and combined to establish a nomogram, which performed well in the customized prediction of CRPC progression at 6th, 12th, 18th and 24th month. The C-index (0.794 and 0.816 for the training and validation cohorts, respectively), calibration curve, and ROC curve all validated the prediction accuracy. DCA curve showed that it could be effective in helping doctors make judgments. The Nomogram-related risk score separated the patients into two groups with notable progression differences.

Conclusion: Severe LUTS was significantly associated with decreased risk for rapid progression to CRPC. The developed nomogram could help identify patients who are at a high risk of rapid CRPC progression and provide tailored follow-up and therapeutic advice.

References

Kyriakopoulos C, Chen Y, Carducci M, Liu G, Jarrard D, Hahn N . Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer: Long-Term Survival Analysis of the Randomized Phase III E3805 CHAARTED Trial. J Clin Oncol. 2018; 36(11):1080-1087. PMC: 5891129. DOI: 10.1200/JCO.2017.75.3657. View

Hussain M, Goldman B, Tangen C, Higano C, Petrylak D, Wilding G . Prostate-specific antigen progression predicts overall survival in patients with metastatic prostate cancer: data from Southwest Oncology Group Trials 9346 (Intergroup Study 0162) and 9916. J Clin Oncol. 2009; 27(15):2450-6. PMC: 2684851. DOI: 10.1200/JCO.2008.19.9810. View

Xia B, Zhao S, Chen Z, Chen C, Liu T, Yang F . Relationship between serum total testosterone and prostate volume in aging men. Sci Rep. 2021; 11(1):14122. PMC: 8266836. DOI: 10.1038/s41598-021-93728-1. View

Rizzo A, Mollica V, Cimadamore A, Santoni M, Scarpelli M, Giunchi F . Is There a Role for Immunotherapy in Prostate Cancer?. Cells. 2020; 9(9). PMC: 7564598. DOI: 10.3390/cells9092051. View

Kirby M, Hirst C, Crawford E . Characterising the castration-resistant prostate cancer population: a systematic review. Int J Clin Pract. 2011; 65(11):1180-92. DOI: 10.1111/j.1742-1241.2011.02799.x. View

Rosellini M, Santoni M, Mollica V, Rizzo A, Cimadamore A, Scarpelli M . Treating Prostate Cancer by Antibody-Drug Conjugates. Int J Mol Sci. 2021; 22(4). PMC: 7913806. DOI: 10.3390/ijms22041551. View

Rizzo A, Santoni M, Mollica V, Fiorentino M, Brandi G, Massari F . Microbiota and prostate cancer. Semin Cancer Biol. 2021; 86(Pt 3):1058-1065. DOI: 10.1016/j.semcancer.2021.09.007. View

Duarsa G, Sari Y, Gde Oka A, Santosa K, Yudiana I, Tirtayasa P . Serum testosterone and prostate-specific antigen levels are major risk factors for prostatic volume increase among benign prostatic hyperplasia patients. Asian J Urol. 2021; 8(3):289-297. PMC: 8356038. DOI: 10.1016/j.ajur.2020.06.001. View

Xu S, Li S, Xu H, Li H, Wu C, Wang W . Haemoglobin, albumin, lymphocyte and platelet predicts postoperative survival in pancreatic cancer. World J Gastroenterol. 2020; 26(8):828-838. PMC: 7052532. DOI: 10.3748/wjg.v26.i8.828. View

10.

Andersson S, Rashidkhani B, Karlberg L, Wolk A, Johansson J . Prevalence of lower urinary tract symptoms in men aged 45-79 years: a population-based study of 40 000 Swedish men. BJU Int. 2004; 94(3):327-31. DOI: 10.1111/j.1464-410X.2004.04930.x. View

11.

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

12.

Yao S, Zhang H, Chen Z, Lin H, Han S, Wu X . Promotion of graphitic carbon oxidation via stimulating CO desorption by calcium carbonate. J Hazard Mater. 2018; 363:10-15. DOI: 10.1016/j.jhazmat.2018.09.048. View

13.

Zhou E, Zhang B, Zhu K, Schaafsma E, Kumar R, Cheng C . A TMPRSS2-ERG gene signature predicts prognosis of patients with prostate adenocarcinoma. Clin Transl Med. 2020; 10(8):e216. PMC: 7711082. DOI: 10.1002/ctm2.216. View

14.

Fizazi K, Tran N, Fein L, Matsubara N, Rodriguez-Antolin A, Alekseev B . Abiraterone acetate plus prednisone in patients with newly diagnosed high-risk metastatic castration-sensitive prostate cancer (LATITUDE): final overall survival analysis of a randomised, double-blind, phase 3 trial. Lancet Oncol. 2019; 20(5):686-700. DOI: 10.1016/S1470-2045(19)30082-8. View

15.

Ma C, Ye D, Li C, Zhou F, Yao X, Zhang S . [Epidemiology of prostate cancer from three centers and analysis of the first-line hormonal therapy for the advanced disease]. Zhonghua Wai Ke Za Zhi. 2008; 46(12):921-5. View

16.

Heetman J, Soeterik T, Wever L, Meyer A, Nuininga J, van Soest R . A side-specific nomogram for extraprostatic extension may reduce the positive surgical margin rate in radical prostatectomy. World J Urol. 2022; 40(12):2919-2924. DOI: 10.1007/s00345-022-04191-0. View

17.

Nguyen H, Xue H, Firlej V, Ponty Y, Gallopin M, Gautheret D . Reference-free transcriptome signatures for prostate cancer prognosis. BMC Cancer. 2021; 21(1):394. PMC: 8040209. DOI: 10.1186/s12885-021-08021-1. View

18.

Irwin D, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S . Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006; 50(6):1306-14. DOI: 10.1016/j.eururo.2006.09.019. View

19.

Magistro G, Keller P, Westhofen T, Schott M, Tamalunas A, Weinhold P . The significance of a high preoperative PSA level for the detection of incidental prostate cancer in LUTS patients with large prostates. World J Urol. 2020; 39(5):1481-1487. DOI: 10.1007/s00345-020-03321-w. View

20.

Zhang S, Xu Y, Hui X, Yang F, Hu Y, Shao J . Improvement in prediction of prostate cancer prognosis with somatic mutational signatures. J Cancer. 2017; 8(16):3261-3267. PMC: 5665042. DOI: 10.7150/jca.21261. View