{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:43:54Z","timestamp":1790023434857,"version":"4.0.1"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to identify patients who would benefit from androgen receptor signaling inhibitor (ARSI) therapy in metastatic hormone\u2010sensitive prostate cancer (mHSPC) with bone metastasis (BM). Therefore, we developed a risk stratification model based on the prognostic impact of BM number.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 244 patients with mHSPC and BM treated with ARSI plus androgen deprivation therapy between March 2018 and November 2024. Prognostic thresholds for BM number were assessed using four cutoffs (\u2265\u20094, \u2265\u20096, \u2265\u200911, and \u2265\u200921). The cutoff with the highest hazard ratio (HR) for castration resistance\u2010free survival (CRFS) was incorporated into a multivariable Cox model along with other clinical variables. Independent prognostic factors were used to construct a risk stratification model, and CRFS and overall survival (OS) were compared with the CHAARTED criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At a median follow\u2010up of 31.3 months, \u2265\u200911 BM showed the strongest prognostic effect for CRFS (HR: 2.62) and OS (HR: 3.01). Multivariable analysis identified \u2265\u200911 BM (HR: 2.47, 95% CI: 1.45\u20134.21,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), \u2265\u2009Gleason score (GS) 9 (HR: 2.07, 95% CI: 1.12\u20133.45,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), and \u2265\u2009cT3b (HR: 2.16, 95% CI: 1.14\u20134.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018) as independent adverse factors. Patients were classified into favorable\u2010risk (no risk factors), intermediate\u2010risk (one risk factor), and poor\u2010risk (two risk factors) groups, which demonstrated significantly different CRFS and OS outcomes (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Compared with the low\u2010volume disease, as defined by the CHAARTED criteria, the favorable\u2010risk group represented a significantly larger proportion of patients (39.3% vs. 26.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) with comparable CRFS (HR: 0.66,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.33) and OS (HR: 0.51,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.18).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This risk model suggests that patients without \u2265\u200911 BM, \u2265\u2009GS9, and \u2265\u2009cT3b may benefit from ARSI plus androgen deprivation therapy for mHSPC. Moreover, it identifies a significantly larger favorable\u2010risk subgroup than the CHAARTED criteria, potentially enhancing clinical precision in treatment selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70152","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:06:21Z","timestamp":1772964381000},"page":"811-820","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Defining Favorable Prognosis in Bone Metastatic Hormone\u2010Sensitive Prostate Cancer Treated With Androgen Receptor Signaling Inhibitors"],"prefix":"10.1002","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0731-2579","authenticated-orcid":false,"given":"Dai","family":"Koguchi","sequence":"first","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Sagamihara Kanagawa 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1681-0567","authenticated-orcid":false,"given":"Kohei","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Sagamihara Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6851-8665","authenticated-orcid":false,"given":"Shuhei","family":"Hirano","sequence":"additional","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Sagamihara Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1017-9799","authenticated-orcid":false,"given":"Masaomi","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Sagamihara Kanagawa 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