%0 Journal Article
%T A novel prognostic model of de novo metastatic hormone-sensitive prostate cancer to optimize treatment intensity.
%A Fujiwara H
%A Kubota M
%A Hidaka Y
%A Ito K
%A Kawahara T
%A Kurahashi R
%A Hattori Y
%A Shiraishi Y
%A Hama Y
%A Makita N
%A Tashiro Y
%A Hatano S
%A Ikeuchi R
%A Nakashima M
%A Utsunomiya N
%A Takashima Y
%A Somiya S
%A Nagahama K
%A Fujimoto T
%A Shimizu K
%A Imai K
%A Takahashi T
%A Sumiyoshi T
%A Goto T
%A Morita S
%A Kobayashi T
%A Akamatsu S
%J Int J Clin Oncol
%V 0
%N 0
%D 2024 Jul 19
%M 39028395
%F 3.85
%R 10.1007/s10147-024-02577-1
%X <B>BACKGROUND: </B>The treatment and prognosis of de novo metastatic hormone-sensitive prostate cancer (mHSPC) vary. We established and validated a novel prognostic model for predicting cancer-specific survival (CSS) in patients with mHSPC using retrospective data from a contemporary cohort.<BR><B>METHODS: </B>1092 Japanese patients diagnosed with de novo mHSPC between 2014 and 2020 were registered. The patients treated with androgen deprivation therapy and first-generation anti-androgens (ADT/CAB) were assigned to the Discovery (N = 467) or Validation (N = 328) cohorts. Those treated with ADT and androgen-receptor signaling inhibitors (ARSIs) were assigned to the ARSI cohort (N = 81).<BR><B>RESULTS: </B>Using the Discovery cohort, independent prognostic factors of CSS, the extent of disease score ≥ 2 or the presence of liver metastasis; lactate dehydrogenase levels > 250U/L; a primary Gleason pattern of 5, and serum albumin levels ≤ 3.7 g/dl, were identified. The prognostic model incorporating these factors showed high predictability and reproducibility in the Validation cohort. The 5-year CSS of the low-risk group was 86% and that of the high-risk group was 22%. Approximately 26.4%, 62.7%, and 10.9% of the patients in the Validation cohort defined as high-risk by the LATITUDE criteria were further grouped into high-, intermediate-, and low-risk groups by the new model with significant differences in CSS. In the ARSIs cohort, high-risk group had a significantly shorter time to castration resistance than the intermediate-risk group.<BR><B>CONCLUSIONS: </B>The novel model based on prognostic factors can predict patient outcomes with high accuracy and reproducibility. The model may be used to optimize the treatment intensity of de novo mHSPC.