{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T08:08:29Z","timestamp":1790842109082,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"14","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"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><jats:sec><jats:title>Objectives<\/jats:title><jats:p>In this study, we aimed to develop and validate a novel risk stratification model integrating Gleason grade and biochemical markers to predict the prognosis of Japanese patients with metastatic hormone\u2010sensitive prostate cancer (mHSPC). We also assessed its clinical utility as a complementary tool to the CHAARTED classification for guiding therapeutic decision\u2010making.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This multicenter retrospective study included patients with mHSPC treated between January 2018 and December 2023 at Yamaguchi University Hospital and its affiliated institutions. Patients who received androgen deprivation therapy combined with either an androgen receptor signaling inhibitor or docetaxel as the initial therapy were included. The primary endpoint was time to castration\u2010resistant prostate cancer (TTCRPC). Independent prognostic factors were identified using multivariable Cox proportional hazards models, and a new risk classification was constructed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 294 patients were analyzed. Multivariable analysis identified Gleason grade group 5, lactate dehydrogenase above the upper limit of normal, and albumin &lt;\u20094.0\u2009g\/dL as independent predictors for TTCRPC. Stratification by the number of these factors (Low, 0\u20131; Intermediate, 2; High, 3) revealed a clear separation of TTCRPC outcomes (median: not reached, 35 months, and 12 months, respectively; log\u2010rank <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Combined with CHAARTED volume classification, high\u2010volume patients with 0\u20131 risk factors had a prognosis similar to low\u2010volume patients, whereas those with \u2265\u20092 factors had significantly poorer outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This novel risk model enabled the refinement of prognostic stratification in conjunction with CHAARTED, facilitating tailored treatment intensity among high\u2010volume patients. Accordingly, further prospective studies are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pros.70019","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T07:53:12Z","timestamp":1753084392000},"page":"1323-1331","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Refining the CHAARTED Classification: Clinical Utility of a Novel Integrated Risk Stratification Model Incorporating Gleason Grade and Biochemical Markers in Japanese Patients With Metastatic Hormone\u2010Sensitive Prostate Cancer"],"prefix":"10.1002","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6703-9268","authenticated-orcid":false,"given":"Takanori","family":"Tokunaga","sequence":"first","affiliation":[{"name":"Department of Urology, Graduate School of Medicine Yamaguchi University Ube Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9279-3156","authenticated-orcid":false,"given":"Keita","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine Yamaguchi University Ube Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Nagao","sequence":"additional","affiliation":[{"name":"Department of Urology Shuto General Hospital Yanai Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kouki","family":"Fujikawa","sequence":"additional","affiliation":[{"name":"Department of Urology and Nephrology Tokuyama Central Hospital Shunan Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Oba","sequence":"additional","affiliation":[{"name":"Department of Urology Saiseikai Yamaguchi General Hospital Yamaguchi Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimio","family":"Takai","sequence":"additional","affiliation":[{"name":"Department of Urology Saiseikai Shimonoseki General Hospital Shimonoseki Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0568-1258","authenticated-orcid":false,"given":"Hiroaki","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Urology Yamaguchi Grand Medical Center Hofu Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeru","family":"Sakano","sequence":"additional","affiliation":[{"name":"Department of Urology Kokura Memorial Hospital Kitakyushu Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Shirataki","sequence":"additional","affiliation":[{"name":"Department of Urology Yamaguchi Rosai Hospital Sanyo\u2010Onoda Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhide","family":"Tei","sequence":"additional","affiliation":[{"name":"Department of Urology Kanmon Medical Center Shimonoseki Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Tabara","sequence":"additional","affiliation":[{"name":"Department of Urology Sanyo\u2010Onoda Municipal Hospital Sanyo\u2010Onoda Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0517-8528","authenticated-orcid":false,"given":"Satoru","family":"Yoshihiro","sequence":"additional","affiliation":[{"name":"Department of Urology Shimonoseki City Hospital Shimonoseki Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Urology Yamaguchi Red Cross Hospital Yamaguchi Yamaguchi 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R. A. H.Hamid C. A.Mochtar andR.Umbas \u201cProstate Specific Antigen (PSA) Kinetic as a Prognostic Factor in Metastatic Prostate Cancer Receiving Androgen Deprivation Therapy: Systematic Review and Meta\u2010Analysis \u201dF1000Research accessed June 1 2025 https:\/\/f1000research.com\/articles\/7-246\/v1.","DOI":"10.12688\/f1000research.14026.1"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.03.036"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2025.01.010"}],"container-title":["The Prostate"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.70019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T13:43:34Z","timestamp":1756215814000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pros.70019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,21]]},"references-count":25,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/pros.70019"],"URL":"https:\/\/doi.org\/10.1002\/pros.70019","archive":["Portico"],"relation":{},"ISSN":["0270-4137","1097-0045"],"issn-type":[{"value":"0270-4137","type":"print"},{"value":"1097-0045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,21]]},"assertion":[{"value":"2025-06-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}