Risk Factors Analysis For Progression To Castration-resistant Prostate Cancer After Prostate Cancer Treated With Endocrine Therapy Within 1 Year

ObjectiveWe retrospectively analyzed the clinical data of 163 cases for prostate cancer patients,who had been treated with endocrine therapy in our hospital.We study the related factors of progression to castration-resistant prostate cancer（CRPC）within 1year after endocrine therapy in prostate cancer patients and explore the possibility of providing early,individualized clinical diagnosis and treatment for high-risk prostate cancer patients,based on early recognition of prostate cancer patients progress into CRPC risk factors.Methods1.A total of 163 patients with prostate cancer who had received androgen deprivation therapy（ADT）as the primary therapy in Department of Urology of Second Affiliated Hospital of Nanchang University from January 2010 to August2017 were enrolled and followed retrospectively.（The follow-up time was until November 2017）2.Recorded the time of endocrine therapy for the patients who progress to CRPC after endocrine therapy.Univariate analysis and multivariate logistic regression analysis were used to analyze the relationship between CRPC and patient age,initial PSA value,PSA density（PSAD）,clinical stage（T stage）,bone metastasis,ISUP grade（Gleason score）,etc.Results1.In this study,163 patients with prostate cancer who had received ADT as the primary therapy were included.The age was（73.69±7.48）years,minimum 49 years,maximum 89 years;initial PSA P25 value 19.05ng/ml,P75 value>100.00ng/ml;Gleason score（7.91±1.15）Scores,minimum 6 scores,maximum 10 scores;PSAD:<0.12ng/（ml.cm3）in 15 patients,（0.12-0.4）ng/（ml.cm3）in 32 patients,>0.4ng/（ml.cm3）76 cases were included in the study.In addition,there were 40 cases that could not be calculated by PSAD due to unquantified PSA,unclear prostate volume,etc.;ISUP 2014 Gleason Classification had 26 cases in 1^st,25 cases in 2^nd grade,29cases in 3^rd grad,41 cases in 4^th grad,and 42 cases in 5^th grade;clinical stage:76cases in T2 stage,41 cases in T3 stage,46 cases in T4 stage.There were 119 cases with bone metastases and 44 cases with negative cases.There were 79 cases treated with surgical castration therapy and 84 cases treated with drug castration therapy.2.Patients enrolled in this study,there were 41 cases progressed to CRPC within one year of endocrine therapy.The rate of CRPC progression within 1 year of endocrine therapy was 25.15%.3.In the univariate analysis,PSAD,clinical stage,bone metastases,ISUP grade were compared among the groups and showed statistical differences in CRPC progression（p<0.05）;Comparison of age,castration treatment Methods,initial PSA values,ISUP 2 and ISUP 3 levels showed that there was no significant difference in CRPC progression（P>0.05）.4.The factors with statistically significance such as PSAD,clinical stage,ISUP grade,bone metastasis were included in the multivariate Logistic regression analysis.The results showed PSAD（HR=1.613,95%CI:1.019².581,P<0.001）,clinical stage（HR=2.268,95%CI:1.157⁴.538,P<0.001）and ISUP grade（HR=2.761,95%CI:1.679⁴.546,P<0.001）were independent risk factors for prostate cancer progression to CRPC within 1 year after endocrine therapy.There was no statistically significant correlation between bone metastases and progression to CRPC within one year after prostate cancer endocrine therapy（p>0.05）.Conclusions1.The rate of progression of CRPC within 1 year after endocrine therapy in prostate cancer patients included in this study was 25.15%.2.In the univariate analysis,PSAD,clinical stage,bone metastasis,ISUP grade were the influencing factors of CRPC progression within 1 year of prostate cancer endocrine therapy.3.In multivariate analysis,PSAD,clinical stage,and ISUP stage were independent risk factors for progression to CRPC within 1 year after endocrine therapy for prostate cancer.But there was no statistically significant on bone metastases in progression to CRPC within 1 year after receiving endocrine therapy;...