A Novel Nomogram for Identifying the Patients at Risk for Rapid Progression of Advanced Hormone-Sensitive Prostate Cancer

Figures & data

Table 1 Clinico-Pathologic Characteristics of Study Participants

Characteristics		Total (n=152)	Severe LUTS
			Yes (n=80)	No (n=72)
Age	<70	56 (36.84%)	21 (26.25%)	35 (48.61%)
	≥70	96 (63.16%)	59 (73.75%)	37 (51.39%)
Gleason sum	7	28 (18.42%)	15 (18.75%)	13 (18.06%)
	8	58 (38.16%)	34 (42.50%)	24 (33.33%)
	9	54 (35.53%)	25 (31.25%)	29 (40.28%)
	10	12 (7.89%)	6 (7.50%)	6 (8.33%)
T-stage	T4	74 (48.68%)	36 (45.00%)	38 (52.78%)
	T3	57 (37.50%)	31 (38.75%)	26 (36.11%)
	T2	21 (13.82%)	13 (16.25%)	8 (11.11%)
N-stage	N1	101 (66.45%)	44 (55.00%)	57 (79.17%)
	N0	51 (33.55%)	36 (45.00%)	15 (21.43%)
M-stage	M1c	19 (12.50%)	9 (11.25%)	10 (13.89%)
	M1a/b	108 (71.05%)	53 (66.25%)	55 (76.39%)
	M0	25 (16.45%)	18 (22.50%)	7 (9.72%)
t-PSA (ng/dl)	<50	25 (16.45%)	17 (21.25%)	8 (11.11%)
	50–100	34 (22.37%)	19 (23.75%)	15 (20.83%)
	>100	93 (61.18%)	44 (55.00%)	49 (68.06%)
HALP	<25	34 (22.37%)	12 (15.00%)	22 (30.56%)
	25–34	30 (19.74%)	14 (17.50%)	16 (22.22%)
	>34	88 (57.89%)	54 (67.50%)	34 (47.22%)
Time to CRPC (months)	Median [min-max]	12.5 [2.00,65.00]	20.5 [3.00,65.00]	7.5 [2.00,43.00]

Abbreviations: CRPC, castration-resistant prostate cancer; LUTS, lower urinary tract symptoms; HALP, hemoglobin, albumin, lymphocyte, and platelet score.

Table 2 Multivariate Analyses of Factors Associated with CRPC Progression

Variable		Multivariate Analysis
		HR (95% CI)	P value
Age	≥70 vs <70	0.993 (0.614–1.605)	0.979
Gleason sum	7	–	–
	8	1.462 (0.776–2.752)	0.239
	9	1.827 (0.991–3.370)	0.053
	10	4.581 (1.518–13.830)	0.007**
T-stage	T2	–	–
	T3	1.150 (0.590–2.245)	0.681
	T4	1.258 (0.660–2.401)	0.486
N-stage	N0 vs N1	1.159 (0.676–1.987)	0.591
M-stage	M0	–	–
	M1a/b	0.735 (0.382–1.418)	0.359
	M1c	0.832 (0.360–1.927)	0.668
t-PSA (ng/dl)	<50	–	–
	50–100	0.752 (0.363–1.556)	0.442
	>100	1.237 (0.663–2.309)	0.503
Severe LUTS	Yes vs No	0.348 (0.205–0.593)	<0.001***
HALP	<18	–	–
	18–35	0.455 (0.233–0.890)	0.021*
	>35	0.131 (0.069–0.250)	<0.001***

Notes: *P < 0.05, **P < 0.01, ***P < 0.001.

Abbreviations: CRPC, castration-resistant prostate cancer; LUTS, lower urinary tract symptoms; HALP, hemoglobin, albumin, lymphocyte, and platelet score.

Figure 1 Establishment and validation of a combined nomogram in the training cohort. (A) Nomogram based on lymphocyte, albumin, HALP score and Gleason sum, was constructed to predict the 0.5-, 1-, 1.5 and 2-year CRPC free survival. (B) Predictive accuracy of the nomogram was assessed by the calibration plots.

Figure 2 Validation of predictive value of the Nomogram in the training cohort. (A) The prognostic value of the nomogram was confirmed by the ROC analysis. (B) Predictive capacity of the nomogram was assessed by DCA.

Figure 3 Validation of predictive capacity of the Nomogram in the validation cohort. (A) Predictive accuracy of the nomogram was assessed by the calibration plots. (B) Predictive capacity of the nomogram was assessed by DCA.

Figure 4 Validation of predictive value of the Nomogram. (A) The prognostic value of the nomogram was confirmed by the ROC analysis in the testing cohort. (B) The CRPC free survival curves based on nomogram correlated risk score in the whole cohort.

Data Sharing Statement

The data analyzed during the current study are available from the corresponding author on reasonable request.