Background Although all participants with prostate cancer (PCa) firstly respond to androgen-deprivation treatment (ADT), after a long period of ADT, nearly all patients with hormone-sensitive prostate cancer (HSPC) progress to castration-resistance prostate cancer (CRPC). With ADT, prostate-specific antigen (PSA) is a significant biomarker of PCa development, with studies indicating that shorter delay to the formation of castration-resistant PCa can be indicated by lower PSA levels and longer time to PSA Nadir time to nadir (TTNs). Aim This study aimed to discover clinical predictors of early responsiveness to ADT that were linked with a less time to castration resistance in metastatic PCa. Patients and methods This retrospective multivariate descriptive analysis study included 100 patients with metastatic prostatic cancer at the Department of Clinical Oncology, Tanta University. Results There was a substantial variation in time to castration resistance across Gleason score groups. There was no substantial connection between time to castration resistance and age, bone metastasis, or starting PSA level; however, there was a significant correlation between time to castration resistance and Gleason score, PSA nadir, and time to PSA nadir. Multivariate Cox regression analysis revealed a substantial connection between Gleason score, PSA nadir, and time to nadir and progress to castration resistance. Initial PSA levels were not substantially associated with progression to castration resistance in multivariate Cox regression analysis. Conclusion Higher Gleason grade group, higher PSA nadir, and shorter TTN were associated with higher risk of progression to castration-resistant PCa in patients with mPCa.
Elsayed et al. (2026) studied this question.