Analysis of risk factors for early progression of prostate cancer after initial endocrine therapy

Abstract

AbstractProlonged androgen deprivation therapy (ADT) in patients with prostate cancer can eventually lead to the development of castration-resistant prostate cancer (CRPC). Once CRPC occurs, the patient's prognosis will be extremely poor. This study explored the time to progression and the predictability of risk factors for CRPC progression based on clinical information and laboratory indicators. Among 159 prostate cancer patients initially treated with ADT, 90 patients were screened for inclusion. Patients progressed to CRPC after endocrine therapy enrolled in Group B, and others enrolled in Group A. Within Group B, they were divided into B1 and B2 Group Based on progression to CRPC within 18 months or not. Multi-factor logistic regression analysis showed that the time to PSA nadir (TTN) (P = 0.031) and serum lactate dehydrogenase (LDH) (P = 0.013) were significantly different between Group A and B. TTN (P < 0.001), LDH (P = 0.001) and platelet to lymphocyte ratio (PLR) (P = 0.005) were significantly different between Group B1 and B2. Kaplan-Meier survival analysis and log-rank tests showed that TTN, LDH and PLR were statistically significantly different in CRPC progression-free survival. The ROC curve showed that the predictive value of TTN (AUC 0.852) (95% CI 0.768–0.942, p < 0.001) was much higher than that of PLR (AUC 0.631) or LDH (0.647) and that the AUC value of TTN combined with PLR and LDH increased to 0.958 (95% CI 0.911–0.997, p < 0.001). In addition, TTN correlated with tumour M-stage and haemoglobin (Hb). In conclusion, we derived independent and combined predictors of early progression to CRPC in prostate cancer patients.