Open AccessNovel metastatic burden‐stratified risk model in de novo metastatic hormone‐sensitive prostate cancer
Author(s) -
Shiota Masaki,
Terada Naoki,
Kitamura Hiroshi,
Kojima Takahiro,
Saito Toshihiro,
Yokomizo Akira,
Kohei Naoki,
Goto Takayuki,
Kawamura Sadafumi,
Hashimoto Yasuhiro,
Takahashi Atsushi,
Kimura Takahiro,
Tabata Kenichi,
Tomida Ryotaro,
Hashimoto Kohei,
Sakurai Toshihiko,
Shimazui Toru,
Sakamoto Shinichi,
Kamiyama Manabu,
Tanaka Nobumichi,
Mitsuzuka Koji,
Kato Takuma,
Narita Shintaro,
Yasumoto Hiroaki,
Teraoka Shogo,
Kato Masashi,
Osawa Takahiro,
Nagumo Yoshiyuki,
Matsumoto Hiroaki,
Enokida Hideki,
Sugiyama Takayuki,
Kuroiwa Kentaro,
Inoue Takahiro,
Sugimoto Mikio,
Mizowaki Takashi,
Kamoto Toshiyuki,
Nishiyama Hiroyuki,
Eto Masatoshi
Publication year - 2021
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/cas.15038
Subject(s) - medicine , prostate cancer , oncology , cohort , androgen deprivation therapy , multivariate analysis , disease , metastasis , retrospective cohort study , prostate , cancer
The metastatic burden is a critical factor for decision‐making in the treatment of metastatic hormone‐sensitive prostate cancer (HSPC). This study aimed to develop and validate a novel risk model for survival in patients with de novo low‐ and high‐burden metastatic HSPC. The retrospective observational study included men with de novo metastatic prostate cancer who were treated with primary androgen‐deprivation therapy at 30 institutions across Japan between 2008 and 2017. We created a risk model for overall survival (OS) in the discovery cohort (n = 1449) stratified by the metastatic burden (low vs high) and validated its predictive ability in a separate cohort (n = 951). Based on multivariate analyses, lower hemoglobin levels, higher Gleason grades, and higher clinical T‐stage were associated with poor OS in low‐burden disease. Meanwhile, lower hemoglobin levels, higher Gleason grade group, liver metastasis, and higher extent of disease scores in bone were associated with poor OS in patients with high‐burden disease. In the discovery and validation cohorts, the risk model using the aforementioned parameters exhibited excellent discriminatory ability for progression‐free survival and OS. The predictive ability of this risk model was superior to that of previous risk models. Our novel metastatic burden‐stratified risk model exhibited excellent predictive ability for OS, and it is expected to have several clinical uses, such as precise prognostic estimation.