TY  - JOUR
A1  - Wenzel, Mike
A1  - Preißer, Felix Martin
A1  - Höh, Robert Benedikt
A1  - Schröder, Maria
A1  - Würnschimmel, Christoph
A1  - Steuber, Thomas
A1  - Heinzer, Hans
A1  - Banek, Séverine
A1  - Ahrens, Marit
A1  - Becker, Andreas
A1  - Karakiewicz, Pierre I.
A1  - Chun, Felix
A1  - Kluth, Luis A.
A1  - Mandel, Philipp
T1  - Impact of time to castration resistance on survival in metastatic hormone sensitive prostate cancer patients in the era of combination therapies
T2  - Frontiers in oncology
N2  - Background: To evaluate the impact of time to castration resistance (TTCR) in metastatic hormone-sensitive prostate cancer (mHSPC) patients on overall survival (OS) in the era of combination therapies for mHSPC.
Material and Methods: Of 213 mHSPC patients diagnosed between 01/2013-12/2020 who subsequently developed metastatic castration resistant prostate cancer (mCRPC), 204 eligible patients were analyzed after having applied exclusion criteria. mHSPC patients were classified into TTCR <12, 12-18, 18-24, and >24 months and analyzed regarding OS. Moreover, further OS analyses were performed after having developed mCRPC status according to TTCR. Logistic regression models predicted the value of TTCR on OS.
Results: Median follow-up was 34 months. Among 204 mHSPC patients, 41.2% harbored TTCR <12 months, 18.1% for 12-18 months, 15.2% for 18-24 months, and 25.5% for >24 months. Median age was 67 years and median PSA at prostate cancer diagnosis was 61 ng/ml. No differences in patient characteristics were observed (all p>0.05). According to OS, TTCR <12 months patients had the worst OS, followed by TTCR 12-18 months, 18-24 months, and >24 months, in that order (p<0.001). After multivariable adjustment, a 4.07-, 3.31-, and 6.40-fold higher mortality was observed for TTCR 18-24 months, 12-18 months, and <12 months patients, relative to TTCR >24 months (all p<0.05). Conversely, OS after development of mCRPC was not influenced by TTCR stratification (all p>0.05).
Conclusion: Patients with TTCR <12 months are at the highest OS disadvantage in mHSPC. This OS disadvantage persisted even after multivariable adjustment. Interestingly, TTCR stratified analyses did not influence OS in mCRPC patients.
KW  - mortality
KW  - survival
KW  - castration resistance
KW  - metastatic prostate cancer
KW  - CRPC
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/61181
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-611817
SN  - 2234-943X
VL  - 11
IS  - art. 659135
SP  - 1
EP  - 8
PB  - Frontiers Media
CY  - Lausanne
ER  -