Materiały źródłowe

• #1 Metastatic Prostate Cancer: Treatment Options & Prognosis | ZERO Prostate Cancer

  https://zerocancer.org/stages-and-grades/metastatic-prostate-cancer

  Metastatic prostate cancer means that the cancer has spread beyond the prostate to distant lymph nodes or organs, often to bones. […] Metastatic prostate cancer or stage IV (4) prostate cancer generally refer to cancer that has spread beyond the lymph nodes and tissues immediately surrounding the prostate. […] More than 60% of men with advanced prostate cancer will eventually develop bone metastases. […] While metastatic prostate cancer is not curable, many factors influence a patient’s prognosis and life expectancy. […] Factors that impact metastatic prostate cancer prognosis include: […] Survival rates for metastatic prostate cancer can vary widely depending on individual factors. According to the American Cancer Society, the 5-year relative survival rate for distant (metastatic) prostate cancer is about 34%.

• #2 Individual prognosis at diagnosis in nonmetastatic prostate cancer: Development and external validation of the PREDICT Prostate multivariable model | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002758

  Prognostic stratification is the cornerstone of management in nonmetastatic prostate cancer (PCa). […] To address this unmet need, we developed an individualised prognostic model that contextualises PCa-specific mortality (PCSM) against other cause mortality, and estimates the impact of treatment on survival. […] A multivariable model estimating individualised 10- and 15-year survival outcomes was constructed combining age, prostate-specific antigen (PSA), histological grade, biopsy core involvement, stage, and primary treatment, which were each independent prognostic factors for PCSM, and age and comorbidity, which were prognostic for NPCM. […] PREDICT Prostate is an individualised multivariable PCa prognostic model built from baseline diagnostic information and the first to our knowledge that models potential treatment benefits on overall survival.

• #3 What Are the Survival Rates for Prostate Cancer? | American Cancer Society

  https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/survival-rates.html

  Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. […] Survival rates cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. […] A relative survival rate compares people with the same type and stage of cancer to people in the overall population. […] The SEER database tracks 5-year relative survival rates for prostate cancer in the United States, based on how far the cancer has spread.

• #4 What to know about metastatic prostate cancer | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/what-to-know-about-metastatic-prostate-cancer.h00-159703068.html

  Metastatic prostate cancer is prostate cancer that has spread outside of the prostate to other parts of the body. This is also known as stage IV disease. […] The average length of survival after a new, metastatic prostate cancer diagnosis is about 5 to 6 years. But its important to remember that prostate cancer is not a one-size-fits-all disease. Survival rates are averages. Some patients will live longer than the average, and some will live less than the average. […] Metastatic prostate cancer goes through two phases, and this impacts the length of survival. […] On average, metastatic prostate cancer takes 2 to 3 years to become castration-resistant, but it could be longer or shorter depending on the features of the cancer. Once the disease reaches this phase, average survival is another 2 to 3 years. […] We havent cured metastatic prostate cancer yet. But were moving in the right direction.

• #5 Metastatic Prostate Cancer—A Review of Current Treatment Options and Promising New Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9856730/

  Prostate cancer is the most common tumor in men. Although there have been many new developments in the last few years, metastatic castration resistant prostate cancer remains a deadly disease. […] The occurrence of de novo metastatic hormone-sensitive disease at the time of initial diagnosis was identified as a poor prognostic factor. The median overall survival (OS) was 51.6 months in low volume disease (HR = 1.64; 95% CI 1.162.31) and 43.2 months in high volume disease (HR = 2.48, 95% CI 1.833.36) compared to the reference group (prior local treatment/low volume disease HR = 1). […] OS in mHSPC patients treated with ADT alone is about 42 months. […] As a result, OS in newly diagnosed metastatic hormone-sensitive prostate cancer is superior for ADT + docetaxel than ADT alone, but that effect of chemotherapy is restricted to high volume disease only.

• #6 Can We Predict Prostate Cancer Metastasis Based on Biomarkers? Where Are We Now?

  https://www.mdpi.com/1422-0067/24/15/12508

  The median survival of patients with a new diagnosis of mPC is 42 months with ADT alone. […] In conclusion, Oncotype DX has more evidence and was designed for the detection of AP or aggressive histology, and the evidence for the prediction of distant metastasis is still poor because, in addition to the two studies described, there is a need for validation of the results and better-quality evidence. […] Decipher was designed as a predictor of metastasis using radical prostatectomy tissue specimens, and, more recently, using needle biopsy specimens. Today, it is the only TBGB tool that can predict metastatic disease and it has been used mainly with unfavorable intermediate- and high-risk patients to define better which patients should receive ADT complementing RT, and in biochemical relapse scenarios to define the best timing to initiate RT. […] There is still a need and space for more cost-effective TBGB tests that predict mPC disease.

• #7 Prostate Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/prostate/hp/prostate-treatment-pdq

  The median age at diagnosis of prostate cancer is 67 years. Prostate cancer may be cured when localized, and it frequently responds to treatment when widespread. The rate of tumor growth varies from very slow to moderately rapid, and some patients may have prolonged survival even after the cancer has metastasized to distant sites, such as bone. The 5-year relative survival rate for men diagnosed in the United States from 2014 to 2020 with local or regional disease was greater than 99%, and the rate for distant disease was 37%; a 97% survival rate was observed for all stages combined. […] The following factors influence the survival of patients with prostate cancer: Extent of tumor. Histological grade of tumor. Patient’s age and health. Prostate-specific antigen (PSA) level. […] When the cancer is confined to the prostate gland, long-term prognosis is excellent. Locally advanced cancer is not usually curable, but 5-year survival is still very good. If prostate cancer has spread to distant organs, current therapy will not cure it. Median survival is usually 1 to 3 years, and most of these patients will die of prostate cancer. Even in this group of patients, indolent clinical courses lasting for many years may be observed.

• #8 Prognosis and survival for prostate cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/prostate/prognosis-and-survival

  If you have prostate cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis. […] Prostate cancer with a lower stage at diagnosis has a more favourable prognosis. Cancer that hasn’t spread outside of the prostate at the time of diagnosis has a better prognosis than cancer that has spread outside of the prostate. […] The lower the Gleason score the better the prognosis. Prostate cancer with a Gleason score lower than 7 has a more favourable prognosis than prostate cancer with a score of 7 or higher.

• #9 Prostate Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/prostate/hp/prostate-treatment-pdq

  Poorly differentiated tumors are more likely to have metastasized before diagnosis and are associated with a poorer prognosis. The most commonly used method to report tumor differentiation is the Gleason score. […] PSA, an organ-specific marker, is often used as a tumor marker. The higher the level of PSA at baseline, the higher the risk of metastatic disease or subsequent disease progression. However, it is an imprecise marker of risk. […] Elevations of serum acid phosphatase are associated with poor prognosis in both localized and disseminated disease. However, serum acid phosphatase levels are not incorporated into the American Joint Committee on Cancer’s staging system for prostate cancer. […] After radical prostatectomy, a detectable PSA level identifies patients at elevated risk of local treatment failure or metastatic disease; however, a substantial proportion of patients with an elevated or rising PSA level after surgery remain clinically free of symptoms for extended periods.

• #10 Prognosis and survival for prostate cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/prostate/prognosis-and-survival

  Some research shows that a higher than normal prostate-specific antigen (PSA) level may indicate a poor prognosis. This is because a high PSA level is linked to a greater risk that prostate cancer will spread. […] PSA doubling time can help doctors find out if a prostate cancer is aggressive, which means it is more likely to grow quickly and spread. Shorter doubling times are linked to a worse prognosis. […] The levels of certain chemicals in the blood can predict a worse prognosis in men with metastatic castrate-resistant prostate cancer. […] These genetic signatures can help doctors make a prognosis. Some genetic signatures are linked to a better prognosis and better response to treatment. Other genetic signatures are associated with a worse prognosis.

• #11 Where Prostate Cancer Spreads In the Body Affects Survival Time | Duke Health

  https://corporate.dukehealth.org/news/where-prostate-cancer-spreads-body-affects-survival-time

  Patients with lymph-only metastasis have the longest overall survival, while those with liver involvement fare worst. […] With the large numbers we analyzed in our study, we were able to compare all of these different sites and provide information that could be helpful in conveying prognosis to patients, Halabi said. […] Most patients, nearly 73 percent, had bone metastases, and their overall median survival was just over 21 months. Men with lymph involvement only were the smallest subset — 6.4 percent — but had the longest median survival at about 32 months. […] Men with liver metastasis represented 8.6 percent of the patients, and had the worst median survival of nearly 14 months. […] These results should help guide clinical decision-making for men with advanced prostate cancer, Halabi said.

• #12 Pretreatment visceral metastases in castration resistant metastatic prostate cancer: role in prediction versus actual site of disease progression | Cancer Imaging | Full Text

  https://cancerimagingjournal.biomedcentral.com/articles/10.1186/s40644-022-00469-z

  To evaluate the anatomic site(s) of initial disease progression in patients with castration resistant metastatic prostate cancer (mCRPC) in the presence or absence of pre-treatment visceral metastases while on systemic therapy. […] Patients with pre-treatment visceral metastases in mCRPC are more likely to experience disease progression of bone disease with the initial anatomic site of progression similar to those without baseline visceral involvement. […] The majority, 80-90% of patients with mCRPC develop osseous metastases, while approximately 36% develop lymph node metastases and 20-30% visceral involvement. […] However the clinical implications of these visceral lesions should not be underestimated. Visceral metastases tend to occur later in the disease course, and patients with visceral involvement have a worse prognosis than those with bone-only disease.

• #13 Predictive Factors of Abiraterone Response in Patients With High-Risk Metastatic Hormone-Sensitive Prostate Cancer

  https://e-juo.org/journal/view.php?number=559

  This study aimed to identify predictive factors for the response to abiraterone in patients with high-risk metastatic hormone-sensitive prostate cancer (mHSPC). […] In the multivariable Cox proportional hazard regression analyses for CRPC-free survival, a Gleason grade of 5 (hazard ratio [HR], 2.888; 95% confidence interval [CI], 1.133-7.361; p=0.026) and bone lesions 10 (HR, 4.194; 95% CI, 1.760-9.997; p=0.001) were significantly associated with CRPC-free survival. […] In the multivariable Cox proportional hazard regression analyses for cancer-specific survival, bone lesions 10 (HR, 3.185; 95% CI, 1.215-8.348; p=0.001) was significantly associated with cancer-specific survival. […] Patients with bone lesions 10 and Gleason grade of 5 are at higher risk of developing CRPC, and bone lesions 10 is at higher risk of cancer-specific survival in high-risk mHSPC treated with abiraterone.

• #14 Development and validation of a nomogram to predict cancer-specific survival in nonsurgically treated elderly patients with prostate cancer | Scientific Reports

  https://www.nature.com/articles/s41598-023-44911-z

  Prostate Cancer (PC) is the most common male nonskin tumour in the world, and most diagnosed patients are over 65 years old. […] Currently, for nonsurgically treated elderly patients, few studies have evaluated their prognostic factors. […] Univariate and multivariate Cox regression model analyses showed that age, race, marital status, TNM stage, chemotherapy, radiotherapy modality, PSA and GS were independent risk factors for predicting CSS in nonsurgically treated elderly PC patients. […] The C-index of the training set and the validation set was 0.894 (95% CI 0.8880.900) and 0.897 (95% CI 0.8870.907), respectively, indicating the good discrimination ability of the nomogram. […] The prognosis evaluation of PC in addition to the traditional TNM stage, PSA and Gleason score (GS) is also very important.

• #15 Frontiers | Population-Based Study of Docetaxel or Abiraterone Effectiveness and Predictive Markers of Progression Free Survival in Metastatic Castration-Sensitive Prostate Cancer

  https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.658331/full

  This article is part of the Research Topic Metastatic Castration Resistant Prostate Cancer: Prognosis and Treatment. […] However, the outcome among mCSPC patients is highly variable, while there is a lack of predictive markers of therapeutic benefit. […] PFS favored the ABI cohort (p = 0.0038, log-rank test), with 78.0% (95%CI 66.4–91.8%) of ABI versus 67.1% (57.5–78.3%) of DOC patients being free of progression at 12 months. […] Age (HR = 0.955), PSA90 (HR = 0.462), and LATITUDE risk stratification (HR = 1.965) remained significantly associated with PFS in multivariable analysis. […] In this real-world group of men undergoing treatment intensification with DOC or ABI for mCSPC, we did not find a significant difference in OS, but PFS was favoring ABI. […] The presence of high-risk mCSPC as per LATITUDE criteria, lack of a PSA90 at 3 months, and younger age at diagnosis of mCPSC predict shorter PFS and as such may identify a cohort of patients in need for further refinement of the initial management.

• #16 Development and validation of a nomogram to predict cancer-specific survival in nonsurgically treated elderly patients with prostate cancer | Scientific Reports

  https://www.nature.com/articles/s41598-023-44911-z

  Our results showed that age, race, marriage, PSA, GS, RT mode, chemotherapy and TNM stage are independent risk factors for elderly prostate patients 3 and 8 years. […] Our prediction model shows that the level of PSA is also an independent risk factor affecting the CSS of PC. […] Our nomogram showed that TNM stage is also an independent risk factor for CSS in elderly nonsurgical PC patients, and patients with distant as well as lymph node metastases have worse outcomes than nonmetastases and higher T stage, which is consistent with previous studies. […] Our nomogram showed that chemotherapy is also an independent risk factor for prognosis, and our KM curve analysis revealed that survival was lower in high-risk and low-risk groups than in patients without chemotherapy. […] Our study developed a predictive model for nonsurgically treated elderly PC patients with all data from the SEER database, and we found that age, race, marriage, TNM stage, PSA, GS, RT modality, and chemotherapy were independent risk factors affecting patient CSS.

• #17

  https://journals.lww.com/md-journal/fulltext/2023/11030/establishment_and_assessment_of_a_nomogram_for.71.aspx

  For the purposes of patients consultation, condition assessments, and guidance for clinicians choices, we developed a prognostic predictive model to evaluate the 1-, 3-, and 5-year overall survival (OS) rates of bone-metastatic prostate cancer (PCa) patients. […] The 5-year survival rate of patients with bone metastases is remarkably lower than that of patients without bone metastases (3% vs 56%). […] Based on demography and clinical pathology, we developed a reliable nomogram to help clinicians more accurately predict the 1-, 3-, and 5-year OS rates of patients with bone metastatic PCa to guide evaluation and treatment. […] The outcomes for patients who were unmarried or separated or divorced or widowed were worse than those of married patients, which is similar to the findings of Udumyan et al and Libby Ellis et al. […] Our nomogram can guide clinicians to accurately predict the 1-, 3-, and 5-year OS for patients with bone metastatic PCa, which will be valuable for patients consultations, clinical evaluations, and choices regarding therapeutic schedules.

• #18 New Prognostic Biomarkers in Metastatic Castration-Resistant Prostate Cancer

  https://www.mdpi.com/2073-4409/10/1/193

  Prostate cancer is one of the most frequent cancers in men and is a common cause of cancer-related death. […] Patient stratification is therefore key in this type of cancer, and there is an urgent need for prognostic biomarkers that can define patients’ risk of cancer-related death. […] Intra-patient tumor heterogeneity and clonal evolution must be taken into account and represent a challenge in the management of patients. Several recurrent molecular pathways have been identified in the metastatic CRPC (mCRPC) molecular landscape, resulting in resistance to treatments and tumor progression, and impacting patients’ survival. […] The efficacy of antagonists in inhibiting a receptor-ligand interaction depends greatly on the concentrations of receptors, agonists, and antagonists. […] The vast majority of patients with AR pathway alterations present AR gene amplifications.

• #19 Can We Predict Prostate Cancer Metastasis Based on Biomarkers? Where Are We Now?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10420177/

  It is important to understand that predicting/preventing metastatic disease is crucial to survival because once a patient has metastatic disease, there is no curative window of time and treatment; there is only palliative treatment that can prolong life. […] Developing and better understanding the role of biomarkers in predicting metastatic disease may be essential in improving PC management and eventually reducing PC mortality. […] This review was motivated by the need for better-known tools that for the prediction of PC metastasis. […] The importance of predicting metastasis is fundamental, given that, once metastasis is diagnosed, QoL and survival drop dramatically. […] However, there is still no strong evidence of its role in the management of unfavorable intermediate- and high-risk non-mPC. […] The use of TBGB for metastasis in PC aids the clinicians therapeutic decision making, focalizing the treatment according to the cancers aggressiveness. […] Therefore, we believe that there is still a need and space for more cost-effective TBGB tests that predict mPC disease.

• #19 Can We Predict Prostate Cancer Metastasis Based on Biomarkers? Where Are We Now?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10420177/

  The incidence of prostate cancer (PC) has risen annually. PC mortality is explained by the metastatic disease (mPC). […] There is indeed a need for more and better tools to predict which patients will progress in the future to non-localized clinical disease or already have micrometastatic disease and, therefore, will clinically progress after primary treatment. […] The importance of predicting metastasis is fundamental given that, once metastasis is diagnosed, quality of life (QoL) and survival drop dramatically. […] Once a diagnosis is made of non-metastatic, clinically significant PC according to risk criteria, a local curative treatment should be offered in order to reduce the risk of metastatic disease and eventually the risk of mortality. […] mPC is by far the main cause of PC mortality.

• #20 Prediction of plasma ctDNA fraction and prognostic implications of liquid biopsy in advanced prostate cancer | Nature Communications

  https://www.nature.com/articles/s41467-024-45475-w

  No consensus strategies exist for prognosticating metastatic castration-resistant prostate cancer (mCRPC). […] ctDNA% strongly predicts overall survival, progression-free survival, and treatment response independent of therapeutic context and outperformed established prognostic clinical factors. […] ctDNA% was significantly elevated in patients with liver metastases on conventional imaging (median ctDNA 42% versus 4.9% in patients with lymph node-only disease, Mann-Whitney U (MWU) p<0.001), detected in 90% of patients compared to only 59% of patients with bone metastases (without visceral involvement) and 57% with lymph node-only disease. [...] Patients with high baseline ctDNA% (30%) had a 5 times greater risk of PSA progression on first-line treatment (95% CI 3.77-7.0, p<0.001) and 5.6 times greater risk of death (95% CI 4.1-7.6, p<0.001) versus patients with ctDNA<2%.

• #21 New Prognostic Biomarkers in Metastatic Castration-Resistant Prostate Cancer

  https://www.mdpi.com/2073-4409/10/1/193

  The presence of AR co-regulators represents another possible mechanism of resistance to treatments. […] All these alterations involving the AR pathway can be studied using liquid biopsies. […] The prognostic impact of AR-V7-positivity on PFS and OS was confirmed. […] The presence of AR gene aberrations that are infrequent in the early stages, but common in the CRPC setting. […] The prognostic role of germline and somatic mutations in HR genes, and specifically of BRCA2 alterations, has been investigated in detail in recent years. […] The role of plasma DNA analysis has been recently investigated in combination with functional imaging and other routinely obtained circulating biomarkers in order to improve prognostication of mCRPC in patients. […] Altogether, these data highlight the relevance of the aberrations in the PTEN pathway as prognostic factor in mCRPC. […] The prognostic role of RB1 and TP53 aberrations was also confirmed by another large retrospective study. […] Here, we presented the most common genomic pathway aberrations in prostate cancer that have an impact on patient outcomes.

• #22 Metastatic Prostate Cancer—A Review of Current Treatment Options and Promising New Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9856730/

  The results of these trials indicated that the combination therapy of ADT and ARSI improved OS in mHSPC patients than ADT alone. Both patient groups, high volume disease and low volume disease had a benefit from combination therapy. […] As a result, Cabazitaxel resulted in longer overall survival and progression-free survival. […] Overall, PSMA RLT showed improved efficacy and lower risk of grade 34 adverse events when compared to Cabazitaxel. […] Prostate cancer is the most common solid cancer in men. In recent years, there have been major advances in the treatment of metastatic prostate cancer, which have pushed frontiers of survival expectations to new levels. ADT alone is not enough anymore for men with metastatic HSPC. Men with BRCA 1/2 alterations and with PSMA-positive cancers benefit from targeted treatment with PARPi or Lu-PSMA, respectively. However, castration resistant prostate cancer remains a deadly disease and new therapies are needed.

• #23 Prostate Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/prostate/hp/prostate-treatment-pdq

  After hormonal therapy, reduction of PSA to undetectable levels provides information regarding the duration of progression-free status; however, decreases in PSA of less than 80% may not be predictive. […] In patients with locally advanced nonmetastatic disease (T2T4, N0N1, and M0), the risk of developing bone metastases is significant. […] Hormonal treatment is the mainstay of therapy for metastatic prostate cancer. Cure is rarely, if ever, possible, but striking subjective or objective responses to treatment occur in most patients. The cornerstone of hormonal therapy for prostate cancer is medical or surgical castration to stop the production of testosterone by the testes. […] The addition of chemotherapy has been shown in randomized trials to improve overall survival compared with ADT alone, with efficacy that appears to be comparable with hormonal therapy, which includes ADT plus abiraterone acetate.

• #24 Prostate Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/prostate/hp/prostate-treatment-pdq

  In a randomized trial, docetaxel has been shown to improve overall survival compared with mitoxantrone. […] In the randomized double-blind LATITUDE trial, 1,199 men with high-risk metastatic castration-sensitive prostate cancer were given ADT plus either abiraterone acetate and prednisone or ADT plus abiraterone-prednisone placebos. […] The addition of docetaxel has been tested in combination with long-term hormone therapy in the first-line management of metastatic prostate cancer and has been shown to improve results more than hormone therapy alone. […] In a randomized trial, the LH-RH agonist leuprolide was as effective as DES in any T, any N, M1 patients, but caused less gynecomastia, nausea and vomiting, and thromboembolisms. […] The use of nonsteroidal antiandrogens as monotherapy decreased overall survival and increased the rate of clinical progression and treatment failure.

• #25 Prostate Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/prostate/hp/prostate-treatment-pdq

  In a randomized trial, the combination of a PARP inhibitor, talazoparib, with enzalutamide was tested in men with mCRPC. […] The phase III, international, open label VISION study enrolled 831 patients with mCRPC previously treated with androgen receptor-directed therapy as well as taxane-based chemotherapy.

• #26 Models predicting survival to guide treatment decision-making in newly diagnosed primary non-metastatic prostate cancer: a systematic review | BMJ Open

  https://bmjopen.bmj.com/content/9/6/e029149

  Men diagnosed with non-metastatic prostate cancer require standardised and robust long-term prognostic information to help them decide on management. […] Few long-term prognostic models exist to inform decision-making at diagnosis of non-metastatic prostate cancer. Improved models are required to inform management and avoid undertreatment and overtreatment of non-metastatic prostate cancer. […] Despite finding a number of published prognostic models, there remains a lack of well-validated, unbiased, generalisable models for use at diagnosis. In particular, there was a lack of external validation and dearth of models that compare outcomes between conservative management and radical treatment. […] The most robust tools we found are the three that have been externally validated namely the Cambridge Prognostic Groups, The SEER Cancer Survival Calculator and the UCSF CAPRA score. However, both have significant shortcomings and are limited in their applicability at diagnosis by failing to include treatment effect, and disregarding non-cancer mortality. Work should focus on developing prognostic models built on long-term survival outcomes which maximally utilise available clinico-pathological information and contextualise PCa within a patients context of competing risks. High quality models including treatment effect are overdue, and crucial if both undertreatment and overtreatment of prostate cancer is to be minimised.

• #27 Prostate Cancer Nomograms | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/nomograms/prostate

  Our prostate cancer nomograms are prediction tools designed to help patients and their physicians understand the nature of their prostate cancer, assess risk based on specific characteristics of a patient and his disease, and predict the likely outcomes of treatment. […] This nomogram predicts the extent of the cancer and long-term results following radical prostatectomy (surgery to remove the prostate gland and surrounding lymph nodes). […] Our post-radical prostatectomy nomogram can be used by patients after their surgical treatment for prostate cancer. This nomogram predicts the probability of remaining cancer recurrence-free at two, five, seven, and ten years following surgery. […] Our salvage radiation therapy nomogram predicts whether a recurrence of prostate cancer after radical prostatectomy can be treated successfully with salvage radiation therapy (external-beam radiation given after the prostate cancer returns).

• #28 Can We Predict Prostate Cancer Metastasis Based on Biomarkers? Where Are We Now?

  https://www.mdpi.com/1422-0067/24/15/12508

  The incidence of prostate cancer (PC) has risen annually. PC mortality is explained by the metastatic disease (mPC). […] There is indeed a need for more and better tools to predict which patients will progress in the future to non-localized clinical disease or already have micrometastatic disease and, therefore, will clinically progress after primary treatment. […] The importance of predicting metastasis is fundamental given that, once metastasis is diagnosed, quality of life (QoL) and survival drop dramatically. […] Current tools that are utilized with several limitations, such as clinical, biochemical and histological parameters, clearly are not sufficient to identify patients that will progress to mPC and those who will not. […] The best approach for monitoring remains challenging for clinicians; biomarkers are being developed and may play an important role.

• #29 Can We Predict Prostate Cancer Metastasis Based on Biomarkers? Where Are We Now?

  https://www.mdpi.com/1422-0067/24/15/12508

  Developing and better understanding the role of biomarkers in predicting metastatic disease may be essential in improving PC management and eventually reducing PC mortality. […] It is important to understand that predicting/preventing metastatic disease is crucial to survival because once a patient has metastatic disease, there is no curative window of time and treatment; there is only palliative treatment that can prolong life. […] The primary goal of any cancer treatment is to reduce the cancer-specific mortality. This is measured through metastasis-free survival, which is a surrogate endpoint for the risk of disease death and overall survival. […] Metastatic hormone-sensitive PC (mHSPC) will inevitably lead to death in a 10-year period. Therefore, it is crucial to treat patients during localized disease and eventually before detecting any signs of clinical metastasis.

• #30 Articles | Journal of Translational Medicine

  https://translational-medicine.biomedcentral.com/articles

  An anti-androgen resistance-related gene signature acts as a prognostic marker and increases enzalutamide efficacy via PLK1 inhibition in prostate cancer. […] Anti-androgen resistance remains a major clinical challenge in the treatment of prostate cancer (PCa), leading to disease progression and treatment failure.

• #31 Metastatic Prostate Cancer: Treatment Options & Prognosis | ZERO Prostate Cancer

  https://zerocancer.org/stages-and-grades/metastatic-prostate-cancer

  It’s essential to discuss your individual prognosis with your healthcare team. […] Remember, while metastatic prostate cancer is a serious diagnosis, many patients can live for several years with appropriate treatment and support. […] Advances in therapies like hormone therapy, chemotherapy, immunotherapy, and targeted agents continue to improve outcomes and quality of life for men with advanced prostate cancer.

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