{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:48:27Z","timestamp":1791996507879,"version":"4.4.0"},"reference-count":13,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["25K12625"],"award-info":[{"award-number":["25K12625"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Radiographic progression (RP) without prostate\u2010specific antigen (PSA) elevation has emerged as a clinically important pattern in the androgen receptor pathway inhibitors (ARPI) era, but its prevalence and prognostic significance in real\u2010world metastatic hormone\u2010sensitive prostate cancer (mHSPC) cohorts remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the prevalence and prognostic implications of RP alone progression in mHSPC patients treated with first\u2010line ARPIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 518 mHSPC patients treated with abiraterone acetate plus prednisolone, enzalutamide, or apalutamide. PSA progression was defined using PCWG3 criteria. Patients were categorized into PSA progression or RP alone progression groups, and clinical outcomes were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 169 patients who developed castration\u2010resistant prostate cancer (CRPC), 34 (20.1%) experienced RP alone. RP alone patients had significantly worse overall survival compared to those with PSA progression (median 21 vs. 39 months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007), despite exhibiting deeper biochemical responses\u2014PSA nadir (0.055 vs. 0.86\u2009ng\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and a higher rate of PSA nadir &lt;\u20090.2\u2009ng\/mL (61.8% vs. 27.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The baseline characteristic differing between groups was CHAARTED volume classification; high volume disease was markedly more common in RP alone patients (94.1% vs. 77.8%). In univariate and multivariate analyses of the overall cohort, CHAARTED high volume disease was identified as an independent risk factor for RP alone (HR 10.3, 95% CI 1.20\u201389.3;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RP alone progression occurred in approximately one\u2010fifth of patients and was associated with significantly poorer survival despite excellent PSA responses, underscoring the limitation of PSA\u2010based monitoring and supporting routine imaging for early detection of PSA\u2010incongruent disease progression in mHSPC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70157","type":"journal-article","created":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T22:10:29Z","timestamp":1773612629000},"page":"882-890","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Prognostic Significance of Radiographic Progression Without PSA Progression in Patients With Metastatic Hormone\u2010Sensitive Prostate Cancer Treated With First\u2010Line ARPI Therapy"],"prefix":"10.1002","volume":"86","author":[{"given":"Takeshi","family":"Tsutsumi","sequence":"first","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki City Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shogo","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki City Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki City Osaka 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 Takatsuki City Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taizo","family":"Uchimoto","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki City Osaka 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"}]},{"given":"Keiichiro","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Urology The Jikei University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1044-912X","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\/0000-0002-2599-8183","authenticated-orcid":false,"family":"Fumihiko Urabe","sequence":"additional","affiliation":[{"name":"Department of Urology The Jikei University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanobu","family":"Saruta","sequence":"additional","affiliation":[{"name":"Department of Urology Fujita\u2010Health University School of Medicine Toyoake City Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuhiko","family":"Yoshizawa","sequence":"additional","affiliation":[{"name":"Department of Urology Fujita\u2010Health University School of Medicine Toyoake City Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Urology Kindai University Faculty of Medicine Sayama City Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saizo","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"Department of Urology Kindai University Faculty of Medicine Sayama City Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyosuke","family":"Nishio","sequence":"additional","affiliation":[{"name":"Department of Urology Kawasaki Medical School Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritoshi","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki City Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuo","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki City Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ko","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki City Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki City Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Nakamori","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki City Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohisa","family":"Matsunaga","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki City Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Yoshikawa","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki City 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 Takatsuki City Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoshi","family":"Takahara","sequence":"additional","affiliation":[{"name":"Department of Urology Fujita\u2010Health University School of Medicine Toyoake City Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1351-1315","authenticated-orcid":false,"given":"Teruo","family":"Inamoto","sequence":"additional","affiliation":[{"name":"Department of Urology Hamamatsu University School of Medicine Hamamatsu Shizuoka 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704174"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1903835"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.00799"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1903307"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-020-01003-9"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2024.04.009"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2022.40.16_suppl.5072"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2020.07.001"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.4487"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.19.9810"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/bco2.212"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.64.2702"}],"container-title":["The Prostate"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.70157","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pros.70157","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.70157","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T13:50:00Z","timestamp":1777729800000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pros.70157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,15]]},"references-count":13,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/pros.70157"],"URL":"https:\/\/doi.org\/10.1002\/pros.70157","archive":["Portico"],"relation":{},"ISSN":["0270-4137","1097-0045"],"issn-type":[{"value":"0270-4137","type":"print"},{"value":"1097-0045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,15]]},"assertion":[{"value":"2025-12-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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