Discordance between PSA level and bone metastatic volume is associated with unfavourable prognosis.
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Ошибки и ограничения
История · было → стало
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Shirafuji Tomoki, Yamada Yasutaka, Sato Kodai, Xue Zhao, Tsujino Takuya, Saito Shinpei, Maenosono Ryoichi, Nishimura Kazuki, Fukushima Tatsuo, Nakamura Ko, Yamamoto Satoshi, Arai Takayuki, Sato Hiroaki, Higuchi Kosuke, Takei Akinori, Kanesaka Manato, Ando Keisuke, Pae Sangjon, Kanaoka Sanji, Takeshita Nobushige, Yoneda Kei, Hino Daichi, Tamura Takaaki, Sazuka Tomokazu, Imamura Yusuke, Fujimura Masaaki, Mikami Kazuo, Nakamura Kazuyoshi, Fukasawa Satoshi, Kurozumi Akira, Naya Yukio, Nagata Maki, Komaru Atsushi, Tobe Toyofusa, Suzuki Noriyuki, Azuma Haruhito, Sakamoto Shinichi
Аннотация
PATIENTS AND METHODS: Clinical data were collected from 526 patients with bone metastatic PCa between 2009 and 2025 from multiple centres. Cancer-specific survival and overall survival (OS) were evaluated as clinical outcomes, and prognostic factors were analysed using multivariate Cox proportional hazard modelling and Kaplan-Meier methods. Survival tree analysis was performed to identify the optimal cut-off for stratifying prognosis. Propensity-score matching (PSM) was used to equalise patient baseline characteristics.
RESULTS: The median age at diagnosis, initial PSA level and BSI were 75 years, 229.8 ng/mL and 1.6%, respectively. Survival tree analysis identified 0.02 as the optimal cut-off for BSI/iPSA ratio. Kaplan-Meier analysis showed that a high BSI/iPSA ratio (≥0.02) was associated with shorter OS compared with a low BSI/iPSA ratio (<0.02; hazard ratio [HR] 1.91; P < 0.0001). Statistical significance remained after PSM analysis (HR 1.63; P = 0.0303). Multivariate analysis showed that a high BSI/iPSA ratio was an independent prognostic factor for OS (HR 2.03; P = 0.0046). Notably, patients with a high BSI/iPSA ratio were less likely to have a PSA progression-only pattern of recurrence (P = 0.0122).
CONCLUSIONS: Discordance between PSA level and bone metastatic volume indicated the presence of non-PSA-producing tumour and was correlated with increased risk of death. Our findings will help facilitate a personalised therapeutic approach for patients with metastatic prostate cancer.