Time to castration-resistant prostate cancer and prostate cancer death according to PSA response in men with non-metastatic prostate cancer treated with gonadotropin releasing hormone agonists

Figures & data

Table 1. Characteristics for men with non-metastatic castration sensitive prostate cancer in the Uppsala-Örebro PSA Cohort and in the Stockholm PSA and Biopsy Register with GnRH as primary treatment.

Variables	UPSAC / STHLM-0 (n = 1 603)
	n (%)
Characteristics collected at date of pre-GnRH PSA
Local clinical T stage
T1	229 (14)
T2	492 (31)
T3	726 (45)
T4	128 (8)
Missing	28 (2)
N stage
N0	91(6)
N1	75 (5)
NX	1437 (90)
M stage
M0	809 (50)
Mx	794 (50)
ISUP grade
ISUP 1	98 (6)
ISUP 2	211 (13)
ISUP 3	293 (18)
ISUP 4	308 (19)
ISUP 5	455 (28)
Fine needle aspiration	173 (11)
Missing	65 (4)
Pre-GnRH PSA
0–10 ng/mL	226 (14)
10–20 ng/mL	264 (16)
20–50 ng/mL	451 (28)
50–100 ng/mL	271 (17)
100–200 ng/mL	188 (12)
200–500 ng/mL	133 (8)
>500 ng/mL	70 (4)
Characteristics collected at date of post-GnRH PSA
Age at post-GnRH PSA, Median (Q1–Q3)	79 (73-84)
Age at post-GnRH PSA
≤60 years	42 (3)
61–70 years	236 (15)
71–80 years	682 (43)
81–90 years	591 (37)
>90 years	52 (3)
Time from GnRH to post-GNRH PSA
90–110 days	535 (33)
111–145 days	539 (34)
146–180 days	529 (33)
Post-GnRH PSA
0–0.2 ng/mL	238 (15)
0.2–0.5 ng/mL	213 (13)
0.5–1 ng/mL	236 (15)
1–2 ng/mL	245 (15)
2–4 ng/mL	229 (14)
4–10 ng/mL	164 (10)
10–40 ng/mL	96 (6)
>40 ng/mL	182 (11)
Civil status*
Married	923 (58)
Widower	251 (16)
Single	429 (27)
Education*
Low (9 years)	833 (52)
Intermediate (9–12 years)	486 (30)
High (>12 years)	284 (18)
CCI**
0	989 (62)
1	308 (19)
2	143 (9)
≥3	163 (10)

Prostate cancer characteristics collected at date of pre-GnRH PSA and post-GnRH PSA.

Q: quartile; M0: no bone metastases on bone scintigraphy; Mx: bone metastases not assessed; ISUP: Pca grading according to the International Society of Urological Pathology; CCI: Charlson comorbidity index.

*Civil status and education from Longitudinal Integration Database for Health Insurance and Labour Market Studies (LISA).

**Charlson comorbidity index based on discharge diagnostic codes in the Swedish Patient Registry.

Figure 1. Heat map of the combined effects of pre-GnRH PSA and post-GnRH PSA on the risk of castration-resistant prostate cancer. The straight parallel level curves indicate that there is no interaction between pre-GnRH PSA and post-GnRH PSA. Since they align vertically, post-GnRH PSA is sufficient to describe the risk of CRPC. The red area reflects an increased risk of CRPC. Time to CRPC was not possible to assess for 50 men (grey area) since they already had reached CRPC at date of post-GnRH PSA.

Figure 2. Risk of castration-resistant prostate cancer according to characteristics at date of pre-GnRH PSA and post-GnRH PSA. C-index and hazard ratios (HR) for univariable and multivariable Cox regression models. Multivariable models included the variables at date of pre-GnRH PSA and post-GnRH PSA. Abbreviations: C: C-index; M0: no metastases on bone scintigraphy; MX: bone metastases not assessed; ISUP: Pca grading according to the International Society of Urological Pathology; CCI: Charlson comorbidity index.

Figure 3. Kaplan-Meier estimates of time to castration-resistant prostate cancer for men in the low-, intermediate- and high-risk groups of CRPC_risk-score. Risk groups are defined by post-GnRH PSA and ISUP grade on diagnostic biopsy. Median time to CRPC was 1.5 years for men above the top tertile and 7.8 years for men bellow the bottom tertile. Shadowing represents 95% confidence interval.

Figure 4. Risk of prostate cancer death for men in the low-, intermediate- and high-risk groups of CRPC_risk-score. Risk groups are defined by post-GnRH PSA and ISUP grade on diagnostic biopsy. Risk of Pca death for men that already had reached CRPC at date of post-GnRH PSA is given by the red curve. Shadowing represents 95% confidence interval.