{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:29:08Z","timestamp":1787563748808,"version":"build-2736575974"},"reference-count":13,"publisher":"Wiley","issue":"14","license":[{"start":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T00:00:00Z","timestamp":1753574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We evaluated the association between initial prostate\u2010specific antigen (iPSA) levels and prognosis in patients with high\u2010risk metastatic hormone\u2010sensitive prostate cancer (mHSPC) and extensive bone metastases treated with androgen receptor signaling inhibitors (ARSI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects and Methods<\/jats:title>\n                    <jats:p>This retrospective study included 276 de novo high\u2010risk mHSPC patients with extensive bone metastases (extent of disease [EOD] score \u2265\u20092) who received ARSI as first\u2010line therapy. The data were collected from institutions participating in the ULTRA Japan Study group. Patient data were collected from institutions affiliated with the ULTRAJ group. Patients were stratified into quartiles based on iPSA levels, and a cutoff value of 200\u2009ng\/mL was used for subgroup analysis. Overall survival (OS) and progression\u2010free survival (PFS) were analyzed using Kaplan\u2013Meier curves and Cox proportional hazards regression models. A restricted cubic spline analysis was conducted to evaluate the nonlinear association between iPSA levels and OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Kaplan\u2013Meier analysis demonstrated significant associations between iPSA quartiles and OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030), with the lowest survival observed in the lowest iPSA group (Q1: &lt;\u2009200\u2009ng\/mL). A spline\u2010based analysis suggested an inverted J\u2010shaped association between iPSA and OS, with the lowest hazard ratio observed at 1664\u2009ng\/mL. Patients with iPSA &lt;\u2009200\u2009ng\/mL exhibited significantly shorter OS than those with higher levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015), while no significant difference in PFS was observed (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.869).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Initial PSA levels were associated with prognosis in high\u2010risk mHSPC with extensive bone metastases. Although patients with relatively low iPSA had significantly shorter OS, those exhibited no significant difference in PFS, suggesting that patients with low iPSA could benefit from ARSI as the 1st line treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70017","type":"journal-article","created":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T14:13:57Z","timestamp":1753625637000},"page":"1307-1314","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prognostic Impact of Initial Prostate\u2010Specific Antigen in Metastatic Hormone\u2010Sensitive Prostate Cancer Patients With Extensive Bone Metastases Under Androgen Receptor Signaling Inhibitor"],"prefix":"10.1002","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4004-6287","authenticated-orcid":false,"given":"Saizo","family":"Fujimoto","sequence":"first","affiliation":[{"name":"Department of Urology Kindai University Faculty of Medicine Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Urology Kaizuka City Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7555-6295","authenticated-orcid":false,"given":"Yutaka","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Urology Kindai University Nara Hospital Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanobu","family":"Saruta","sequence":"additional","affiliation":[{"name":"Department of Urology Fujita Health University School of Medicine Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuhiko","family":"Yoshizawa","sequence":"additional","affiliation":[{"name":"Department of Urology Fujita Health University School of Medicine Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoshi","family":"Takahara","sequence":"additional","affiliation":[{"name":"Department of Urology Fujita Health University School of Medicine Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1559-1889","authenticated-orcid":false,"given":"Takuya","family":"Tsujino","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9045-5484","authenticated-orcid":false,"given":"Ryoichi","family":"Maenosono","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Yoshikawa","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1044-912X","authenticated-orcid":false,"given":"Wataru","family":"Fukuokaya","sequence":"additional","affiliation":[{"name":"Department of Urology The Jikei University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7410-0712","authenticated-orcid":false,"given":"Takafumi","family":"Yanagisawa","sequence":"additional","affiliation":[{"name":"Department of Urology The Jikei University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5673-1553","authenticated-orcid":false,"given":"Takahiro","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Urology The Jikei University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1157-4101","authenticated-orcid":false,"given":"Takeshi","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Urology Tokyo Medical University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Hirasawa","sequence":"additional","affiliation":[{"name":"Department of Urology Tokyo Medical University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshio","family":"Ohno","sequence":"additional","affiliation":[{"name":"Department of Urology Tokyo Medical University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6774-7497","authenticated-orcid":false,"given":"Kazutoshi","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Urology Kindai University Faculty of Medicine Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-024-02637-6"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-024-02649-2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pros.24855"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-018-0353-4"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.21873\/invivo.12268"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2024.102140"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2490-14-33"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2018.01.043"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-12-3791"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/aja.aja_24_18"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2019.05.029"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-19-1587"}],"container-title":["The Prostate"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.70017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T13:43:39Z","timestamp":1756215819000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pros.70017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,27]]},"references-count":13,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/pros.70017"],"URL":"https:\/\/doi.org\/10.1002\/pros.70017","archive":["Portico"],"relation":{},"ISSN":["0270-4137","1097-0045"],"issn-type":[{"value":"0270-4137","type":"print"},{"value":"1097-0045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,27]]},"assertion":[{"value":"2025-05-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}