Analysis Of Factors Related To Second Progression Of Castration-resistant Prostate Cancer Treated With Abiraterone Acetate

Objective:To analyze the relationship between the clinical factors and the second resistant to abiraterone of patient with prostate cancer undergoing endocrine therapy progressing to castration-resistant prostate cancer Method:The clinical data of 61 patients with AA who were treated in the Second Affiliated Hospital and the First Affiliated Hospital of Nan Chang University from2015.01 to 2020.12 were analyzed retrospectively.The relationship between age,PSA,PSA nadir,clinical stage(TNM stage),Gleason score,EOD score of bone metastasis,Time To Castration-Resistant Prostate Cancer(TTCRPC)were analyzed by single factor Cox,and the relationship between the factors and the progress of patients after oral abiraterone was analyzed.Then,the important factors were selected for Cox analysis.The independent risk factors were selected for ROC curve analysis,and the cutoff value group was found and the progression free survival analysis was performed by Kaplan Meier method.The optimal critical value group was found by ROC curve for the life time without progress,the critical factors were found by chi square test or t-test,and the risk degree of important related factors was analyzed by binary logistic regression analysis.Result:Sixty one patients were followed up with the CRPC to the time of recurrence or deadline,with an average survival time of 10.54±5.25 months.The single factor Cox regression analysis suggested that TTCRPC(HR = 0.941,P = 0.002),the minimum PSA(HR = 1.802,P < 0.001)and Gleason score(HR = 2.215,P = 0.047)were the risk factors for the recurrence of AA treated CRPC.Multivariate Cox regression analysis showed that TTCRPC(HR = 0.955,P = 0.023),and PSA minimum(HR =1.529,P = 0.001)were independent risk factors for the recurrence of progress of the CRPC treated with abiraterone.ROC curve shows that AUC of TTCRPC is0.752±0.062 P=0.001,and the best critical value is 13.3 months.The K-M survival curves of TTCRPC and PSA showed that the median progression free survival period of TTCRPC < 13.3 month group and TTCRPC 3 13.3 month group was 6.37 months and 15.73 months(Log Rank P < 0.001),the lowest PSA value < 0.2 ng/ml group and PSA minimum value 0.2 ng/ml group were 16.63 months and October 07(Log Rank P=0.012).ROC showed that AUC of progression free survival was 0.734±0.063p=0.002,and the best critical value was 8.15 months.The difference between TTCRPC(c2 = 17.224,P < 0.001),PSA minimum value(c2 = 3.949,P = 0.047)and Gleason score(c2 = 3.880,P = 0.049)was statistically significant.The analysis of binary logistic regression model showed that after adjusting the influence of PSA minimum and Gleason score,the risk of progress in TTCRPC 3 13.3 month group was lower than that of TTCRPC < 13.3 month group(OR = 0.079,P = 0.002).ConclusionTTCRPC and PSA nadir are important predictors of recurrence resistant to AA in patients with CRPC.The longer TTCRPC is and the lower the PSA minimum,the longer the patient will progress again.The longer TTCRPC,the lower the risk of recurrence in 8.15 months.