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Inicio Actas Urológicas Españolas (English Edition) Factors related to early castration resistance in metastatic prostate cancer. Re...
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Vol. 43. Issue 10.
Pages 562-567 (December 2019)
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Vol. 43. Issue 10.
Pages 562-567 (December 2019)
Original article
Factors related to early castration resistance in metastatic prostate cancer. Results from the National Prostate Cancer Registry in Spain
Factores relacionados con la resistencia a la castración precoz en el cáncer de próstata metastásico. Resultados del Registro nacional de cáncer de próstata en España
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M.A. Lloret-Duráa,
Corresponding author
marcossant.lloret@gmail.com

Corresponding author.
, J. Panach-Navarretea, J.M. Martínez-Jabaloyasa, L. Valls-Gonzáleza, J.M. Cózar-Olmob, B. Miñana-Lópezc, F. Gómez-Veigad, A. Rodríguez-Antolíne, Grupo Español de Cáncer de Próstata
a Servicio de Urología, Hospital Clínico Universitario. Valencia. Facultat de Medicina i Odontologia. Universitat de València. Spain
b Servicio de Urología, Hospital Virgen de las Nieves, Granada, Spain
c Servicio de Urología, Clínica Universidad de Navarra. Navarra, Spain
d Servicio de Urología, C.H.U.A.C., Hospital Universitario de Salamanca. Salamanca, Spain
e Servicio de Urología, Hospital Gregorio Marañón, Madrid, Spain
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Table 1. Baseline characteristics of the sample
Table 2. Analysis of predictive variables of castration-resistant prostate cancer. Univariate survival model
Table 3. Analysis of predictive variables of castration-resistant prostate cancer. Multivariate survival model
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Abstract
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 < 0,001), mean age (73,3 ± 8,3 years in non CR, 69,1 ± 9,3 in CR p = 0.01), mean PSA nadir (15,5 ± 57,3 ng/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 < 0,001).

Multivariate analysis: the independent variables associated to CR are age (HR: 0.96. 95% CI: 0.94-0.99, p = 0.01), PSA nadir (HR: 1.65. 95% CI: 1,43–1,91, p < 0,001), and T3-T4 stage (HR: 2.11. 95% CI: 1.10–4.04, p = 0.02).

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.

Keywords:
Prostate cancer
Castration resistance
Prognostic factors
Resumen
Introducción

Objetivo del estudio fue establecer los factores que se relacionan de forma independiente con el desarrollo de resistencia a la castración (RC) a medio plazo en el cáncer de próstata (CP).

Material y métodos

155 pacientes con CP metastásicos al diagnóstico del registro nacional de CP con un seguimiento de hasta 39 meses.

Las variables estudiadas fueron: edad, PSA, nadir de PSA, Gleason, invasión perineural, estadios T, N y M, y tipo de bloqueo (intermitente/continuo).

Resultados

Media de seguimiento 26,2 ± 13,4 meses. 47,1% desarrolló RC precoz, con una media hasta el desarrollo de RC 12,2 ± 8,7 meses.

Análisis univariante, se relacionaron con la RC la media de PSA (290 ± 905,1 ng/mL en no RC, 519,1 ± 1437,2 ng/mL en RC, <0,001), media de edad (73,3 ± 8,3 años en no RC, 69,1 ± 9,3 en RC, p = 0,01), media de nadir de PSA (15,5 ± 57,3 ng/mL en no RC, 15,9 ± 23,7 ng/mL en RC, <0,001), Gleason (en ≥8, HR:2,11. IC 95%: 1,22–3,65, p = 0,006), y estadio T (en T3-T4, HR: 2,85. IC 95%: 1,57–5,19, <0,001).

Análisis multivariante, las variables independientes relacionadas con la RC son, edad (HR:0,96. IC95%:0,94–0,99, p = 0,01), nadir de PSA (HR:1,65. IC95%:1,43–1,91, p < 0,001), y estadio T3-T4 (HR:2,11. IC95%:1,10-4,04, p = 0,02).

Conclusiones

El nadir de PSA y un estadio tumoral T3-T4 al diagnóstico se relacionan con un riesgo aumentado de desarrollar RC. Además, la edad al diagnóstico se muestra como una variable que disminuye el riesgo, de forma que, a más edad, menos riesgo de desarrollar RC a medio plazo.

Palabras clave:
Cáncer de próstata
Resistencia a la castración
Factores pronósticos

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