Risk factor analysis and nomogram construction in patients with distant metastatic prostate cancer at different PSA...

Area of Science:

• Oncology
• Urology
• Medical Statistics

Background:

• Prostate cancer (PCa) is a leading male malignancy, with metastatic disease posing significant treatment challenges.
• Effective prognostic models are crucial for managing advanced PCa and guiding patient care.

Purpose of the Study:

• To analyze prognostic risk factors in distant metastatic PCa stratified by prostate-specific antigen (PSA) levels.
• To develop predictive models for overall survival (OS) and cancer-specific survival (CSS) in these patients.

Main Methods:

• Utilized data from the SEER database for PCa patients with distant metastases.
• Stratified patients into PSA <20 ng/mL and PSA ≥20 ng/mL groups.
• Employed COX regression, nomogram construction, and survival curve analyses (Kaplan-Meier, timeROC).

Main Results:

• Identified distinct prognostic factors for OS and CSS in both PSA groups (e.g., age, marital status, stage, Gleason score, income).
• Specific factors like ethnicity and bone metastasis showed varying importance across PSA levels.
• A validated nomogram demonstrated accuracy in predicting patient prognosis.

Conclusions:

• Prognostic factors for metastatic PCa differ significantly based on baseline PSA levels.
• The developed nomogram provides a valuable tool for clinical decision-making and patient stratification.
• Further research can refine these models for personalized PCa management.