MP22-04 INVESTIGATING THE IMPACT OF A LOWER TESTOSTERONE THRESHOLD ON CASTRATION-RESISTANT PROGRESSION IN PATIENTS ON CONTINUOUS ANDROGEN DEPRIVATION THERAPY
Notice bibliographique
Résumé
You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) II (MP22)1 Apr 2019MP22-04 INVESTIGATING THE IMPACT OF A LOWER TESTOSTERONE THRESHOLD ON CASTRATION-RESISTANT PROGRESSION IN PATIENTS ON CONTINUOUS ANDROGEN DEPRIVATION THERAPY Maylynn Ding*, Taehyoung Lee, Richard Di Lena, and Bobby Shayegan Maylynn Ding*Maylynn Ding* More articles by this author , Taehyoung LeeTaehyoung Lee More articles by this author , Richard Di LenaRichard Di Lena More articles by this author , and Bobby ShayeganBobby Shayegan More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555588.43900.cfAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Androgen deprivation therapy (ADT) is a first-line treatment for advanced prostate cancer and an adjuvant for localized treatment of high-risk disease. There is debate regarding optimal medical castration levels. We aimed to determine if a lower testosterone level below the previously accepted castration level of <50ng/dL has an impact on time to progression to castration-resistant prostate cancer (CRPC) in patients on continuous ADT. METHODS: This is a single-center, retrospective review of prospectively collected data on 156 consecutive patients who initiated continuous ADT at a tertiary centre from 2006 to 2017. Serum prostate-specific antigen (PSA) and testosterone levels were routinely assessed every 3 months after initiation of ADT. Patients were stratified based on absolute testosterone levels measured at 6 and 9 months following ADT initiation. Progression to CRPC was assessed using the Kaplan-Meier method and compared with the log-rank analysis. RESULTS: A total of 116 patients were included in the study. There were no baseline differences in age and pre-treatment PSA levels between groups. Median follow-up was 48 months (IQR: 30.5, 62.5). 41.4% of all patients were CRPC free at the date of last follow-up. In this study cohort, 71.6% of patients achieved a one-year mean testosterone level <20ng/dL; 21.6% achieved 20-32ng/dL; 3.4% achieved 32-50 ng/dL; and 3.4% achieved ≥50ng/dL. Patients who achieved an absolute testosterone level of <20ng/dL at 6 months had a significantly increased time to CRPC (log-rank p=0.025, median CRPC-free survival of 48 months [<20ng/dL] versus 24 months [≥20 ng/dL]). Likewise, patients with a 9-month absolute testosterone level <20ng/dL had a significantly increased time to CRPC (log-rank p=0.039, median CRPC-free survival 48 months [<20ng/dL] versus 20 months [≥20ng/dL]). CONCLUSIONS: Our study results support that strict testosterone control of <20ng/dL in patients undergoing continuous ADT will lead to longer progression free survival. In this series, only a small proportion of patients had one-year mean testosterone levels of ≥32ng/dL (6.9%). A multi-centre prospective study is needed to validate these findings. Source of Funding: None Hamilton, Canada; New York, NY; Hamilton, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e317-e318 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maylynn Ding* More articles by this author Taehyoung Lee More articles by this author Richard Di Lena More articles by this author Bobby Shayegan More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,019 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».