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Clinical outcomes and prognostic factors in patients with newly diagnosed metastatic prostate cancer initially treated with androgen deprivation therapy: a retrospective multicenter study in Japan

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Abstract

Purpose

Clinical outcomes of patients with newly diagnosed metastatic hormone-naïve prostate cancer (mHNPC) and initially treated with androgen deprivation therapy (ADT) were evaluated.

Methods

The medical records of 605 consecutive mHNPC patients with initial ADT or combined androgen blockade (CAB) at nine study centers between 2008 and 2016 were retrospectively reviewed. Castration-resistant prostate cancer (CRPC)-free and overall survival (OS) were estimated by the Kaplan–Meier method. The association of pretreatment risk factors with CRPC-free survival and OS was evaluated by Cox proportional hazard models and differences in survival were classified by the number of risk factors.

Results

Median follow-up was 2.95 years, median CRPC-free survival was 21.9 months and median OS was 5.37 years. Multivariable analysis found that four risk factors, a Gleason score ≥ 9, lymph node metastasis, an extent of disease score ≥ 2, and serum LDH of > 220 IU were independently associated with both CRPC-free survival and OS. Median CRPC-free survival of low-risk patients with no or one factor was 86.5 months, 17.9 months in intermediate-risk patients with two or three factors, and 11.0 months in high-risk patients with four factors. Median OS was 4.72 years in intermediate- and 2.44 years in high-risk patients. It was not reached in low-risk patients.

Conclusion

In this series, CRPC-free and OS of a subset of mHNPC patients in Japan who were treated with ADT or CAB had better CRPC-free and overall survivals in Japan. Risk-adapted treatment based on the presence of novel prognostic factors may be beneficial for selected mHNPC patients.

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Acknowledgements

We express our appreciation to Yoko Mitobe, Yukiko Sugiyama, Masako Nagata and Saeko Nakamura for their assistance in performing this study.

Funding

This study was supported in part by research grants from the MEXT/JSPS (Kakenhi, No. 19K09663).

Author information

Authors and Affiliations

  1. Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan

    Shintaro Narita, Hiromi Sato, Atsushi Koizumi & Tomonori Habuchi

  2. Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan

    Shingo Hatakeyama & Chikara Ohyama

  3. Department of Urology, Tohoku University School of Medicine, Sendai, Japan

    Masahiro Takahashi, Koji Mitsuzuka & Yoichi Arai

  4. Department of Urology, Yamagata University School of Medicine, Yamagata, Japan

    Toshihiko Sakurai & Norihiko Tsuchiya

  5. Department of Urology, Miyagi Cancer Center, Natori, Japan

    Sadafumi Kawamura & Tatsuo Tochigi

  6. Department of Urology, Yamagata Prefectural Central Hospital, Yamagata, Japan

    Senji Hoshi

  7. Department of Urology, Iwate Prefectural Isawa Hospital, Oshu, Japan

    Masanori Ishida & Jiro Shimoda

  8. Department of Urology, Aomori Prefectural Central Hospital, Aomori, Japan

    Toshiaki Kawaguchi

  9. Department of Urology, Sendai City Hospital, Sendai, Japan

    Shigeto Ishidoya

  10. Department of Public Health, Akita University School of Medicine, Akita, Japan

    Kyoko Nomura

  11. Michinoku Japan Urological Cancer Study Group (MJUCSG), Sendai, Japan

    Shintaro Narita, Shingo Hatakeyama, Masahiro Takahashi, Toshihiko Sakurai, Sadafumi Kawamura, Senji Hoshi, Masanori Ishida, Toshiaki Kawaguchi, Shigeto Ishidoya, Jiro Shimoda, Koji Mitsuzuka, Tatsuo Tochigi, Norihiko Tsuchiya, Chikara Ohyama, Yoichi Arai & Tomonori Habuchi

Authors
  1. Shintaro Narita
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  2. Shingo Hatakeyama
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  17. Yoichi Arai
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  19. Tomonori Habuchi
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Contributions

Narita: Data collection, statistical analysis, manuscript writing. Hatakeyama, Takahashi, Sakurai, Kawamura, Ishida, Sato, Mitsuzuka: Data collection. Hoshi, Kawaguchi, Ishidoya, Shimoda, Protocol development. Nomura: Data analysis. Tochigi, Tsuchiya, Ohyama, Arai, Habuchi: manuscript editing, supervision. All authors had read and approve of the final manuscript.

Corresponding author

Correspondence to Shintaro Narita.

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Narita, S., Hatakeyama, S., Takahashi, M. et al. Clinical outcomes and prognostic factors in patients with newly diagnosed metastatic prostate cancer initially treated with androgen deprivation therapy: a retrospective multicenter study in Japan. Int J Clin Oncol 25, 912–920 (2020). https://doi.org/10.1007/s10147-019-01614-8

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  • DOI: https://doi.org/10.1007/s10147-019-01614-8

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