ArticleFrontiers in oncology2026
Early Initiation of novel hormonal therapy is associated with improved survival in synchronous bone-metastatic hormone-sensitive prostate cancer: a retrospective cohort study from China.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The incidence and prognosis of synchronous bone-metastatic hormone-sensitive prostate cancer (SBM-HSPC) in contemporary China remain unclear. This study aimed to determine its current prevalence, characterize patient profiles, and identify independent prognostic factors. Methods: We conducted a retrospective cohort study of patients with SBM-HSPC diagnosed at a major tertiary center in China (2017-2023). Demographic, clinicopathological, treatment, and outcome data were analyzed. Overall survival (OS) was evaluated using Kaplan-Meier and Cox regression. A landmark analysis (3- and 6-month) was employed to assess the association between early treatment initiation and OS, mitigating immortal time bias. Results: The incidence of SBM-HSPC was 6.09%. The cohort presented with high-risk features: 93.1% had Gleason score ≥8,and 83.7% had high-volume disease (HVD). The median OS was 43 months. Multivariate analysis identified HVD as an independent risk factor (HR = 2.37, P = 0.012) and age 60-74 years as protective (HR = 0.52, P = 0.040) compared to age <60. Landmark analysis demonstrated that initiation of novel hormonal agents (NHA) within 3 months was associated with a 45% reduction in mortality risk (HR = 0.55, P<0.001), an association sustained at 6 months. In contrast, early use of docetaxel or bone-targeting agents was not associated with improved OS. Conclusion: The incidence of SBM-HSPC in this Chinese cohort aligns with data from developed healthcare systems. HVD is a key prognostic determinant. Early initiation of NHA therapy is strongly associated with a significant survival benefit, underscoring the critical need for timely, intensive systemic treatment in this high-risk patient population.
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