The real prevalence and clinical courses of non-metastatic castration-resistant prostate cancer: A retrospective single-institutional study

Abstract

Abstract Background The real prevalence and clinical course of patients with non-metastatic castration-resistant prostate cancer (nmCRPC) remain unclear. In this study, we comprehensively examined the prevalence of nmCRPC in patients who were treated for localized prostate cancer at a single institution. Methods We retrospectively investigated the clinical records of 1,929 patients who were treated for localized prostate cancer between 2005 and 2018. From this population, we counted patients who progressed to nmCRPC. We summarized the characteristics of nmCRPC patients, including the duration from initial diagnosis to nmCRPC and from nmCRPC to mCRPC or death. Kaplan–Meier analysis was performed to analyze overall and metastasis-free survival. Results We identified 22 nmCRPC patients among 1,929 patients who were initially treated at our institution and a further 23 nmCRPC patients who were initially treated at other institutions. The median time from the initial diagnosis of prostate cancer to the diagnosis of nmCRPC was 5.9 years (range, 0.2–19.1 years). Median metastasis-free and overall survival from the diagnosis of nmCRPC was 5.2 and 6.3 years, respectively. Conclusion A detailed investigation of patients with localized prostate cancer who were treated at our institution revealed that only 1.1% of them progressed to nmCRPC during the median follow-up period of 5.5 years. Their clinical courses were long, and the length of treatment duration varied remarkably among cases.