J Urol Oncol.  2023 Nov;21(3):264-270. 10.22465/juo.234600520026.

Nonregional Lymph Node Metastasis as a Predictor of Early Progression When Using Androgen Receptor Targeting Agents in Patients With Metastatic Castration-Resistant Prostate Cancer Without Previous Chemotherapy

• Kim S
• Rho BY
• Kang DH
• Chung DY

• KMID: 2553959
• DOI: http://doi.org/10.22465/juo.234600520026

Abstract

Purpose
In present, the use of androgen receptor targeting agents (ARTA) is one of the standard treatments for metastatic castration-resistant prostate cancer (mCRPC) without previous chemotherapy. However, some patients may experience early progression despite ARTA use. Therefore, we analyzed predictors of early progression.
Materials and Methods
We retrospectively analyzed patients treated with ARTA for mCRPC before chemotherapy at Inha University Hospital. Patients were divided into an early progression group and a late progression group. The 2 groups were defined as a group that used ARTA for more than 1 year without progression and a group that did not. Clinical and pathological parameters were analyzed to evaluate the oncologic outcomes. Univariate and multivariate logistic regression analyses were used to predict progression markers.
Results
The final analysis included 70 patients. The mean progression-free duration with ARTA use was 334.90±364.716 days. There were 44 and 26 patients in the early and late progression groups, respectively. Univariate and multivariate logistic regression analyses did not show statistically significant results for the ARTA medication type, body mass index, Gleason grade group, visceral metastasis, bone metastasis, regional lymph node (LN) metastasis, time to CRPC, and prostate-specific antigen kinetics. In contrast, age (odds ratio [OR], 1.154; 95% confidence interval [CI], 1.043–1.251) and nonregional LN metastasis (OR, 8.819; 95% CI, 1.165–66.746) were significantly associated with the progression-free duration of ARTA use in multivariate logistic regression analysis.
Conclusions
We think that nonregional LN metastasis is a predictor of early progression when using ARTA in patients with mCRPC without previous chemotherapy.

Keyword

Castration-resistant prostatic neoplasms; Abiraterone acetate; Enzalutamide; Lymphatic metastasis