Scientific publications

Factors related to early castration resistance in metastatic prostate cancer. Results from the National Prostate Cancer Registry in Spain

Jul 10, 2019 | Magazine: Actas Urológicas Españolas

Lloret-Durá MA (1), Panach-Navarrete J (2), Martínez-Jabaloyas JM (2), Valls-González L (2), Cózar-Olmo JM (3), Miñana-López B (4), Gómez-Veiga F (5), Rodríguez-Antolín A (6); Grupo Español de Cáncer de Próstata.

(1) Servicio de Urología, Hospital Clínico Universitario de Valencia, Facultat de Medicina i Odontologia, Universitat de València, Valencia, España.
(2) Servicio de Urología, Hospital Clínico Universitario de Valencia, Facultat de Medicina i Odontologia, Universitat de València, Valencia, España.
(3) Servicio de Urología, Hospital Virgen de las Nieves, Granada, España.
(4) Servicio de Urología, Clínica Universidad de Navarra, Pamplona, España.
(5) Servicio de Urología, C.H.U.A.C., Hospital Universitario de Salamanca, Salamanca, España.
(6) Servicio de Urología, Hospital Gregorio Marañón, Madrid, España.


INTRODUCTION:

The objective of the study was to determine the factors independently related with the development of castration resistance (CR) in prostate cancer (PC) in the medium term.

MATERIAL AND METHODS:

155 patients diagnosed with metastatic PC with a follow-up of up to 39 months. Data taken from the National PC Registry. The evaluated variables were age, PSA, nadir PSA, Gleason, perineural invasion, TNM stages, and ADT type (intermittent/continuous).

RESULTS:

Mean follow-up 26,2±13,4 months. 47.1% developed early CR, with mean time until onset of 12,2±8,7 months. Univariate analysis the mean PSA was correlated with CR (290±905,1 ng/mL in non CR, 519,1±1437,2 ng/mL in CR, P<.001), mean age (73,3±8,3 years in non CR, 69,1±9,3 in CR P=.01), mean PSA nadir (15,5±57,3ng/mL in non CR, 15,9±23,7 ng/mL in CR, p<0,001), Gleason (in ≥8, HR:2,11. 95% CI: 1.22-3.65, p=0.006), and T stage (in T3-T4, HR: 2.85. 95% CI: 1.57-5.19, P<.001). Multivariate analysis the independent variables associated to CR are age (HR: 0.96. 95% CI: 0.94-0.99, P=.01), PSA nadir (HR: 1.65. 95% CI: 1,43-1,91, P<.001), and T3-T4 stage (HR: 2.11. 95% CI: 1.10-4.04, P=.02).

CONCLUSIONS:

PSA nadir and T3-T4 tumor stage at diagnosis are associated to an increased risk of developing CR. In addition, age at diagnosis is shown as a variable that decreases risk. Therefore, an older age would be associated with lower risk probability of CR in the medium term.

CITATION Actas Urol Esp. 2019 Jul 10. pii: S0210-4806(19)30072-5. doi: 10.1016/j.acuro.2019.04.001

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