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Prognostic impact of C-reactive protein-albumin ratio for the lethality in castration-resistant prostate cancer

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Abstract

This study aimed to assess the clinical value of C-reactive protein-albumin ratio (CAR) at the initiation of first-line treatment for castration-resistant prostate cancer (CRPC). We identified 221 CRPC patients treated with either androgen-signaling inhibitors (ASIs: abiraterone and enzalutamide) or docetaxel as the first-line treatment. The value of CAR was evaluated at the initiation of first-line treatment. The optimal cutoff value of CAR for the prediction of lethality was defined by the receiver operating characteristic curve and the Youden Index. The primary endpoints of the study included overall survival (OS) and cancer-specific survival (CSS). The median age was 74 years. The optimal cutoff value of CAR in newly diagnosed CRPC patients was 0.5 (CAR > 0.5: n = 77 and CAR ≤ 0.5: n = 144). The 3-year OS and CSS rate in patients with CAR > 0.5 were significantly lower than those with CAR ≤ 0.5 (OS: 30.9% vs 55.5%, p < 0.001) (CSS: 42.5% vs 65.4%, p < 0.001). A multivariate analysis consistently demonstrated that CAR was an independent predictor for both OS and CSS. When stratified by the first-line treatments, patients with CAR > 0.5 has significantly shorter CSS than those with CAR ≤ 0.5 in abiraterone (median of 23 vs 49 months, p < 0.001) and enzalutamide (median of 23 vs 41 months, p = 0.0016), whereas no difference was observed in patients treated with docetaxel as the first-line treatment (median of 34 and 37 months, p = 0.7708). Despite the limited cohort size and retrospective design, increased CAR seemed to serve as an independent predictor of OS and CSS for patients newly diagnosed with CRPC.

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Funding

This work was partially supported by Grant-in-Aid No. 19K18624 (Japan Society for the Promotion of Science: JSPS), the Uehara Memorial Foundation, the NOVARTIS Foundation (Japan) for the Promotion of Science, Japan Research Foundation for Clinical Pharmacology, Yamaguchi Endocrine Disease Research Foundation, and the Takeda Science Foundation 2018 in Japan.

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Authors and Affiliations

  1. Department of Urology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan

    Taizo Uchimoto, Kazumasa Komura, Yuya Fujiwara, Kenkichi Saito, Naoki Tanda, Takeshi Tsutsumi, Yuki Yoshikawa, Hirofumi Uehara, Hajime Hirano, Hayahito Nomi, Naokazu Ibuki, Teruo Inamoto & Haruhito Azuma

  2. Department of Urology, Saiseikai-Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka City, Osaka, 530-0012, Japan

    Taizo Uchimoto

  3. Translational Research Program, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan

    Kazumasa Komura, Kohei Taniguchi & Tomohito Tanaka

  4. Department of Urology, Osaka Medical College Mishima-Minami Hospital, 8-1 Tamagawa-shinmachi, Takatsuki City, Osaka, 569-0856, Japan

    Tomohisa Matsunaga & Koichiro Minami

  5. Department of Urology, Aijinkai-Takatsuki Hospital, 1-3-13 Kosobecho, Takatsuki City, Osaka, 569-1192, Japan

    Atsushi Ichihashi

  6. Division of Urology, Department of Surgery, Brigham and Women’s Hospital, 75 Francis St, Boston, MA, 02115, USA

    Takuya Tsujino & Tomoaki Takai

  7. Department of Urology, Hirakata Municipal Hospital, 2-14-1 Kinyahonmachi, Hirakata City, Osaka, 573-1013, Japan

    Yudai Nishimoto

  8. Department of Urology, Fujita-Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake City, Nagoya, Aichi, 470-1192, Japan

    Kiyoshi Takahara

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  1. Taizo Uchimoto
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  2. Kazumasa Komura
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  22. Haruhito Azuma
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Corresponding author

Correspondence to Kazumasa Komura.

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All authors declared that they have no conflict of interest.

Ethical approval

The study design was approved in the institutional review board of Osaka Medical College (IRB Approval Number: RIN-750-2571).

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Uchimoto, T., Komura, K., Fujiwara, Y. et al. Prognostic impact of C-reactive protein-albumin ratio for the lethality in castration-resistant prostate cancer. Med Oncol 37, 9 (2020). https://doi.org/10.1007/s12032-019-1332-7

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