Clinical prediction of benefits from preoperative maximum androgen blocking therapy in high-risk localized prostate cancer
10.13406/j.cnki.cyxb.003795
- VernacularTitle:高危局限性前列腺癌术前最大雄激素阻断治疗获益的临床预测
- Author:
Yong HUANG
1
;
Fulin ZHOU
;
Jing LI
;
Yao ZHANG
Author Information
1. 重庆医科大学附属第一医院泌尿外科,重庆 400016
- Keywords:
high-risk localized prostate cancer;
maximum andro-gen blocking therapy;
radical prostatectomy;
prostate-specific anti-gen density;
nomogram
- From:
Journal of Chongqing Medical University
2025;50(4):463-469
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To develop a predictive model for selecting patients with high-risk localized prostate cancer(HRLPC)who are suitable for preoperative maximum androgen blocking(MAB)therapy.Methods:This study was conducted among 96 patients with HRLPC who were diagnosed based on transrectal biopsy and underwent radical prostatectomy in Department of Urology,The First Af-filiated Hospital of Chongqing Medical University,from January 1,2021 to June 30,2024,and all patients received MAB therapy for 3 months before surgery and were followed up for 6 months after surgery.Related data were collected from all patients,including baseline demographic features,laboratory data,imaging findings,perioperative data,and follow-up information.At first,the association between prostate-specific antigen density(PSAD)stratification after MAB therapy and pathological and biochemical benefits was analyzed to determine the optimal PSAD group,then machine learning was used to identify important variables and establish a predictive model,and finally,the model was evaluated using the ROC curve,the calibration curve,and clinical applicability assessment.Results:The low PSAD group[PSAD<0.17 ng/(mL·cm3)]showed the best results of perioperative outcomes,pathological downgrading,the rate of undetectable PSA after-surgery,recovery from urinary incontinence,and PSA follow-up(P<0.05).The model was established based on prostate volume,low-density lipoprotein cholesterol,PSAD,smoking history,total cholesterol,PSA,and body mass index,and this predictive model had good performance(with an area under the ROC curve of 0.769)and showed a certain degree of clinical applica-bility.Conclusion:Patients in the low PSAD group tend to have better pathological and biochemical benefits.This study provides a re-liable predictive model to assist in the individualized treatment of patients with HRLPC.
