Analysis Of Related Factors Influencing The Prognosis Of Abiraterone Acetate In The Treatment Of CRPC

Objective:Analyzing the relevant risk factors affecting the prognosis of abiraterone acetate in the treatment of castration-resistant prostate cancer(CRPC)provides a preliminary basis for screening prostate cancer patients who are suitable for abiraterone acetate treatment.Methods:First,retrospectively analyze 53 castration-resistant prostate cancer patients diagnosed and treated with abiraterone at the Second Affiliated Hospital of Nanchang University from November 1,2016 to November 1,2021.Then,use Cox univariate analysis to analyze the relation among age,ISUP(International Society of Urological Pathology)prostate cancer classification grouping,initial PSA,lowest value of PSA after treatment,rate of PSA decline,duration of ADT treatment,the EOD score of bone metastasis and prognosis.The statistically significant indicators were analyzed by Cox multi-factors.Finally,the kaplan-Meier method and the binary Logistic method were used for survival analysis.Results:Finally,53 eligible CRPC patients were followed up to the deadline or midway death,with a median follow-up time of 39 months.The results of Cox univariate regression analysis showed that the ISUP prostate cancer grading group(HR = 4.106,95%CI: 2.299-7.333,P = 0.000),the lowest value of PSA(HR = 9.316,95%CI2.160-40.180,P = 0.003),TTCRPC(HR = 0.163,95%CI:0.055-0.489,P = 0.001)and EOD score of bone metastasis(HR = 3.299,95% CI 1.858-5.858,P = 0.000)were risk factors affecting the prognosis of desmoresistant prostate cancer treated with abiraterone acetate.The results of Cox multivariate regression analysis showed that the ISUP prostate cancer grading group(HR= 2.902,95% CI: 1.565-5.380,P=0.001)and the lowest value of PSA(HR=5.365,95% CI:1.140-25.244,P=0.034)were independent risk factors affecting the prognosis of prostate cancer treated with abiraterone acetate.According to ROC curve analysis,the AUC of ISUP prostate cancer grading group is 0.874 ± 0.049,P = 0.000,and the best critical value is 3.5.K-M survival curve analysis showed that the median OS of patients with the ISUP prostate cancer grading group < 4 and ≥ 4 were 55 months and 23.5 months,and the difference was statistically significant(log rank P = 0.000);The median OS of patients with n PSA values < 0.2ng/ml and ≥ 0.2ng/ml were 51 months and 29 months,and the difference was statistically significant(log rank P = 0.000).Conclusion:ISUP prostate cancer grading group and n PSA are important predictors of the prognosis of prostate cancer CRPC in AA treatment.The lower the ISUP prostate cancer classification group and n PSA value,the better prognosis of patients.Therefore,we can predict whether patients will prefer AA treatment after progressing to CRPC by early grouping based on the patient’s ISUP prostate cancer classification and detecting the lowest value to which PSA drops during ADT treatment.