Prediction of Time to Castration-Resistant Prostate Cancer Using Bone Scan Index in Men with Metastatic Hormone-Sensitive Prostate Cancer

Urol Int. 2017;99(4):400-405. doi: 10.1159/000477131. Epub 2017 Jun 14.

Abstract

Introduction: We evaluated bone scan index (BSI) as a predictive biomarker for time to castration-resistant prostate cancer (CRPC) in patients with metastatic hormone-sensitive prostate cancer (mHSPC).

Materials and methods: We identified 85 consecutive mHSPC patients treated with first-line androgen deprivation therapy. We analyzed the correlations between time to CRPC and clinicopathological characteristics, including age, prostate-specific antigen (PSA) level, Gleason score, clinical TNM stage, hemoglobin, lactate dehydrogenase, C-reactive protein, and BSI.

Results: The median BSI was 2.7%. Progression to CRPC occurred in 55 (64.7%) patients and the median time to CRPC was 12.9 months. In multivariate analysis, 3 significant risk factors for time to CRPC were identified: age (>73 vs. ≤73 years; hazard ratio [HR] 0.53), p = 0.038, PSA level (>270 vs. ≤270 ng/mL; HR 0.53, p = 0.038), and BSI (>2.7 vs. ≤2.7%; HR 2.97, p < 0.001).

Conclusion: Age, PSA level, and BSI were found to be significant predictive factors for time to CRPC in patients with mHSPC.

Keywords: Biomarkers; Castration-resistant; Prostatic neoplasms; Radionuclide imaging.

MeSH terms

  • Adenocarcinoma / blood
  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / secondary*
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Androgen Antagonists / therapeutic use
  • Bone Neoplasms / drug therapy
  • Bone Neoplasms / secondary*
  • Disease Progression
  • Drug Resistance, Neoplasm
  • Humans
  • Kallikreins / blood
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms, Hormone-Dependent / blood
  • Neoplasms, Hormone-Dependent / drug therapy
  • Neoplasms, Hormone-Dependent / pathology*
  • Neural Networks, Computer
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / pathology*
  • Prostatic Neoplasms, Castration-Resistant / blood
  • Prostatic Neoplasms, Castration-Resistant / diagnostic imaging
  • Prostatic Neoplasms, Castration-Resistant / drug therapy
  • Prostatic Neoplasms, Castration-Resistant / pathology*
  • Radiographic Image Interpretation, Computer-Assisted
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Tomography, X-Ray Computed

Substances

  • Androgen Antagonists
  • KLK3 protein, human
  • Kallikreins
  • Prostate-Specific Antigen