The critical role of radiographic assessment at the time of castration-resistant prostate cancer (CRPC) diagnosis is underscored by this study. We performed a retrospective analysis of radiographic changes in metastasis from the time of diagnosis of metastatic hormone-sensitive prostate cancer (mHSPC) to CRPC diagnosis. We also explored its impact on prognosis post-CRPC. We retrospectively analyzed 98 men who underwent radiographic examinations (bone scans and computed tomography [CT]) at the time of CRPC diagnosis. When radiographic studies demonstrated progression at CRPC diagnosis, patients were assigned to the radiographic progressive disease (rPD) group. The remaining patients were placed in the "non-rPD" group. The overall survival (OS) post-CRPC was compared between the 2 groups. The median OS post-CRPC was significantly shorter in the rPD group (n = 50) compared to the non-rPD group (n = 48) (32 months vs. not reached, = .0124). Multivariate analysis showed that radiographic progression and shorter time to CRPC were associated with a shorter OS post-CRPC (hazard ratio [HR] = 3.14; 95% confidence interval [CI], 1.21-8.12, = .019). Radiographic progression at the point of CRPC diagnosis independently predicts a shorter OS post-CRPC in patients with mHSPC. Therefore, assessing radiographic changes at the time of CRPC diagnosis could be instrumental in managing CRPC in patients with mHSPC.

中文翻译：

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去势抵抗性前列腺癌诊断中的放射学进展：转移性激素敏感前列腺癌的预后指标

这项研究强调了放射学评估在去势抵抗性前列腺癌 (CRPC) 诊断时的关键作用。我们对从转移性激素敏感性前列腺癌 (mHSPC) 诊断到 CRPC 诊断期间转移的影像学变化进行了回顾性分析。我们还探讨了其对 CRPC 后预后的影响。我们回顾性分析了 98 名在 CRPC 诊断时接受放射检查（骨扫描和计算机断层扫描 [CT]）的男性。当放射学研究显示 CRPC 诊断时进展时，患者被分配到放射学进展性疾病 (rPD) 组。其余患者被置于“非 rPD”组。比较两组 CRPC 后的总生存期 (OS)。与非 rPD 组 (n = 48) 相比，rPD 组 (n = 50) 的 CRPC 后中位 OS 显着缩短（32 个月与未达到，= 0.0124）。多变量分析显示，影像学进展和 CRPC 时间缩短与 CRPC 后 OS 缩短相关（风险比 [HR] = 3.14；95% 置信区间 [CI]，1.21-8.12，= 0.019）。 CRPC 诊断时的影像学进展独立预测 mHSPC 患者 CRPC 后 OS 较短。因此，评估 CRPC 诊断时的影像学变化可能有助于管理 mHSPC 患者的 CRPC。