Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 11;16(2):e54036.
doi: 10.7759/cureus.54036. eCollection 2024 Feb.

Remission Depth in Metastatic Hormone-Sensitive Prostate Cancer Is Associated With Prognosis in Patients With Initial Prostate-Specific Antigen Values Above 100 Ng/ML

Takeshi Azuma  1 , Akimasa Katsumata  1 , Masato Kano  1 , Koji Tsumura  1
Affiliations

Remission Depth in Metastatic Hormone-Sensitive Prostate Cancer Is Associated With Prognosis in Patients With Initial Prostate-Specific Antigen Values Above 100 Ng/ML

Takeshi Azuma et al. Cureus. .

Abstract

Introduction: Recently, new drugs have caused a paradigm shift in the treatment of metastatic hormone-sensitive prostate cancer (HSPC). Meanwhile, research has identified several prognostic factors of metastatic HSPC.

Objective: The present study focused on remission depth in metastatic HSPC and evaluated its association with remission depth.

Method: We analyzed 427 patients diagnosed with metastatic HSPC with serum initial prostate-specific antigen (PSA) > 100 ng/ml. The nadir serum PSA value was used as a marker of remission depth for each duration to castration resistance by using receiver operating characteristic (ROC) curves. Cox proportional hazards regression was used to assess for any correlation of progression-free survival (PFS) and overall survival (OS) with the nadir PSA level.

Results: The cut-off value for the nadir PSA level per time to castration resistance (TTCR) at three, five, seven, and nine years was calculated. The nadir PSA value alone was able to predict prognosis because of its high sensitivity, high specificity, and high AUC in ROC analysis. The nadir PSA level can be an independent prognostic marker not only for TTCR but also for OS on multivariate analysis.

Conclusion: We identified the cut-off value for nadir PSA per TTCR period in patients with metastatic HSPC. The nadir PSA value alone can predict prognosis; this demonstrates utility in routine clinical practice due to its simplicity and accuracy.

Keywords: hormonal therapy; metastatic hormone-sensitive prostate cancer; prognosis; prostate-specific antigen; remission depth.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Distribution of initial PSA value.
PSA, prostate-specific antigen
Figure 2
Figure 2. ROC curve analysis of nadir PSA value for each TTCR (3 (A), 5 (B), 7 (C), and 9 (D) years).
PSA, prostate-specific antigen; AUC, under the curve
Figure 3
Figure 3. Kaplan-Meier survival curves for OS stratified by nadir PSA value.
The cutoff values were 0.21 (A), 0.10 (B), and 0.036 ng/ml (C). Kaplan-Meier survival curves for PFS stratified by nadir PSA value(D). PSA, prostate-specific antigen
Figure 4
Figure 4. Kaplan-Meier survival curves for OS divided by nadir PSA value.
The cutoff values were 0.21 (A), 0.10 (B), and 0.036 ng/ml(C). Kaplan-Meier survival curves for OS stratified by nadir PSA value (D). PSA, prostate-specific antigen
See this image and copyright information in PMC

References

    1. Apalutamide for metastatic, castration-sensitive prostate cancer. Chi KN, Agarwal N, Bjartell A, et al. N Engl J Med. 2019;381:13–24. - PubMed
    1. Enzalutamide with standard first-line therapy in metastatic prostate cancer. Davis ID, Martin AJ, Stockler MR, et al. N Engl J Med. 2019;381:121–131. - PubMed
    1. Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer. Fizazi K, Tran N, Fein L, et al. N Engl J Med. 2017;377:352–360. - PubMed
    1. 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. Fizazi K, Tran N, Fein L, et al. Lancet Oncol. 2019;20:686–700. - PubMed
    1. Abiraterone for prostate cancer not previously treated with hormone therapy. James ND, de Bono JS, Spears MR, et al. N Engl J Med. 2017;377:338–351. - PMC - PubMed

LinkOut - more resources