Abstract：
OBJECTIVE: In recently published phase III trials, overall survival (OS) differences were demonstrated in patients with secondary vs. De Novo and low vs. high volume metastatic hormone-sensitive prostate cancer (mHSPC). We hypothesized that these factors may also be attributable in real-world setting of new intensified combination therapies and in metastatic castration resistant prostate cancer (mCRPC) patients.
METHODS: We relied on an institutional tertiary-care database to identify mHSPC and subsequent mCRPC patients. The main outcome consisted of time to mCRPC and OS. Patients were stratified according to De Novo vs. secondary and low vs. high volume mHSPC and mCRPC, respectively.
RESULTS: Of 504 mHSPC patients, 371 (73.6%) were De Novo vs. 133 (26.4%) secondary mHSPC. Patients with De Novo and high volume mHSPC harbored shorter time to mCRPC and OS than secondary and low volume mHSPC patients (both P < 0.01). After stratification regarding disease volume, median time to mCRPC differed significantly between De Novo high volume (DNHV) vs. De Novo low volume (DNLV) vs. secondary high volume (SecHV) vs. secondary low volume mHSPC patients (SecLV, P < 0.001). Similarly in OS analyses, median OS was 44 vs. 53 vs. 88 vs. 120 months for respectively DNHV vs. SecHV vs. SecLV vs. DNLV mHSPC (P < 0.001). After progression to mCRPC, the effect of onset of metastatic disease and metastatic volume was still observed (all P < 0.01).
CONCLUSIONS: Patients with DNHV mHSPC harbor worse prognosis in a real world setting and in the light of combination therapies. This effect is also discernible in the context of mCRPC.
METHODS: We relied on an institutional tertiary-care database to identify mHSPC and subsequent mCRPC patients. The main outcome consisted of time to mCRPC and OS. Patients were stratified according to De Novo vs. secondary and low vs. high volume mHSPC and mCRPC, respectively.
RESULTS: Of 504 mHSPC patients, 371 (73.6%) were De Novo vs. 133 (26.4%) secondary mHSPC. Patients with De Novo and high volume mHSPC harbored shorter time to mCRPC and OS than secondary and low volume mHSPC patients (both P < 0.01). After stratification regarding disease volume, median time to mCRPC differed significantly between De Novo high volume (DNHV) vs. De Novo low volume (DNLV) vs. secondary high volume (SecHV) vs. secondary low volume mHSPC patients (SecLV, P < 0.001). Similarly in OS analyses, median OS was 44 vs. 53 vs. 88 vs. 120 months for respectively DNHV vs. SecHV vs. SecLV vs. DNLV mHSPC (P < 0.001). After progression to mCRPC, the effect of onset of metastatic disease and metastatic volume was still observed (all P < 0.01).
CONCLUSIONS: Patients with DNHV mHSPC harbor worse prognosis in a real world setting and in the light of combination therapies. This effect is also discernible in the context of mCRPC.
摘要：
目的：在最近发表的III期试验中，总体生存（OS）差异在继发性与DeNovo和低vs.高体积转移性激素敏感型前列腺癌（mHSPC）。我们假设，这些因素也可能归因于新的强化联合疗法的现实环境和转移性去势抵抗前列腺癌（mCRPC）患者。
方法：我们依靠机构三级护理数据库来识别mHSPC和随后的mCRPC患者。主要结果包括mCRPC和OS的时间。根据DeNovo和次要和低vs.高容量mHSPC和mCRPC，分别。
结果：在504名mHSPC患者中，371（73.6%）是DeNovovs.133（26.4%）次mHSPC。DeNovo和高容量mHSPC患者的mCRPC和OS时间均短于继发性和低容量mHSPC患者（均P<0.01）。在对疾病体积进行分层后，到mCRPC的中位时间在DeNovo高容量（DNHV）与DeNovo低容量(DNLV)与次级高容量(SecHV)与继发性低容量mHSPC患者(SecLV，P<0.001)。同样，在操作系统分析中，中位OS为44vs.53vs.88vs.分别为120个月的DNHV与SecHVvs.SecLVvs.DNLVmHSPC(P<0.001)。进展到mCRPC后，仍观察到转移性疾病的发作和转移体积的影响（均P<0.01）。
结论：DNHVmHSPC患者在现实环境中和根据联合疗法的预后较差。这种效应在mCRPC的上下文中也是可辨别的。
方法：我们依靠机构三级护理数据库来识别mHSPC和随后的mCRPC患者。主要结果包括mCRPC和OS的时间。根据DeNovo和次要和低vs.高容量mHSPC和mCRPC，分别。
结果：在504名mHSPC患者中，371（73.6%）是DeNovovs.133（26.4%）次mHSPC。DeNovo和高容量mHSPC患者的mCRPC和OS时间均短于继发性和低容量mHSPC患者（均P<0.01）。在对疾病体积进行分层后，到mCRPC的中位时间在DeNovo高容量（DNHV）与DeNovo低容量(DNLV)与次级高容量(SecHV)与继发性低容量mHSPC患者(SecLV，P<0.001)。同样，在操作系统分析中，中位OS为44vs.53vs.88vs.分别为120个月的DNHV与SecHVvs.SecLVvs.DNLVmHSPC(P<0.001)。进展到mCRPC后，仍观察到转移性疾病的发作和转移体积的影响（均P<0.01）。
结论：DNHVmHSPC患者在现实环境中和根据联合疗法的预后较差。这种效应在mCRPC的上下文中也是可辨别的。
