Korean J Urol Oncol.  2021 Feb;19(1):48-59. 10.22465/kjuo.2021.19.1.48.

The Real-World Experience of Single-Center, Retrospective Study of the Prognostic Effect of Secondary Hormone Agent on Survival in Patients With Hormone-Refractory Metastatic Prostate Cancer

• Kim SH
• Lee DE
• Seo HK
• Chung J
• Joung JY

• KMID: 2513367
• DOI: http://doi.org/10.22465/kjuo.2021.19.1.48

Abstract

Purpose
This study aimed to analyze the overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with either combination or only secondary hormone therapy (2ndHTx) or docetaxel chemotherapy.
Materials and Methods
Between 2005 and 2018, 307 mCRPC patients’ medical records were retrospectively reviewed treated with either 2ndHTx (HTx [N=73, 23.8%] either abiraterone acetate or enzalutamide), docetaxel+2ndHTx (CTx-HTx [N=90, 29.3%]) or only docetaxel therapy (CTx-only [N=144, 46.9%]). The Cox proportional hazard model for risk factors of OS and Kaplan-Meier analysis with log-rank test for OS comparison among three therapeutic groups with a statistical significance of p＜0.05.
Results
During a median 49.6-month follow-up and a median 22 months of OS, the worst OS was observed in CTx-only (17.7 months) followed by the CTx-HTx (22.9 months), and only-HTx (42.6 months) groups (p＜0.001). The baseline comparison showed that age, body mass index, TN stagings, and prostate specific antigen level were significantly different between groups (p＜0.05). In the multivariable analysis for the risk factors of OS, age (hazard ratio [HR], 0.978), cT3–4 stage (HR, 1.606), and HTx (HR, 0.482) were significant factors. With the HTx agents, enzalutamide was the only left risk factor for OS regardless of underlying diseases (HR, 0.511; p＜0.001). The group analyses for the OS showed that only-CTx group (HR, 2.696) and CTx-HTx group (HR, 1.434) were unfavorable factors for OS with a reference of HTx group (p＜0.001).
Conclusions
2ndHTx was a significant prognostic factor for OS regardless of underlying diseases in patients with mCRPC and improved OS in comparison with docetaxel.

Keyword

Metastatic prostate cancerㆍPrognosisㆍSurvivalㆍHormonal agentsㆍCastration-resistant prostatic neoplasms