Prognostic Significance of 3-Month Prostate-specific Antigen Level Following Androgen-deprivation Therapy in Metastatic Hormone-sensitive Prostate Cancer

Background/Aim: We examined the prognostic use of the 3-month prostate-specific antigen (PSA3m) level after androgen-deprivation therapy in patients with de novo metastatic hormone-sensitive prostate cancer (mHSPC). Patients and Methods: The present study included 145 patients with mHSPC who received primary androgen deprivation therapy. Results: The optimal cutoff PSA3m value for prediction of 5-year overall survival was 2.56 ng/ml (area under the receiver operating characteristics curve=0.67) using a time-dependent receiver operating characteristic (survival ROC) curve. In patients with CHAARTED low-volume and LATITUDE low-risk disease, the median overall survival was longer for patients with low PSA3m than that for those with high PSA3m. Multivariate analysis revealed PSA3m (hazard ratio=1.99; p=0.006) and age >= 80 years as independent risk factors for overall survival in patients with mHSPC. Conclusion: PSA3m can be a useful prognostic biomarker to avoid excessive upfront combination therapy, particularly in elderly patients with low-volume and low-risk mHSPC.