{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:24:17Z","timestamp":1785525857033,"version":"3.56.0"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100014422","name":"Eli Lilly Japan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014422","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>Metastatic hormone\u2010sensitive prostate cancer (mHSPC) remains clinically heterogeneous despite upfront treatment intensification. The commonly used CHAARTED high\u2010volume and LATITUDE high\u2010risk criteria stratify metastatic burden but do not explicitly incorporate Eastern Cooperative Oncology Group (ECOG) performance status (PS). We developed and internally assessed a simple bedside prognostic score integrating PS with aggressive metastatic burden in a real\u2010world mHSPC cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively identified consecutive patients with histologically confirmed prostate adenocarcinoma who initiated first\u2010line androgen deprivation therapy (ADT)\u2013based systemic therapy for mHSPC between January 2014 and May 2025. Metastases were assessed primarily by conventional imaging (bone scintigraphy and computed tomography [CT]). The PS\u2013Metastatic Burden score (0\u20132) assigned 1 point each for ECOG PS\u2009\u2265\u20091 and for aggressive metastatic burden defined as bone scan extent of disease (EOD)\u2009\u2265\u20093 and\/or liver metastasis. The primary endpoint was overall survival (OS). Model fit and discrimination were compared with CHAARTED and LATITUDE using Akaike information criterion (AIC) and Harrell's concordance index (C\u2010index) in a common complete\u2010case dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 886 patients (median follow\u2010up 36.9 months), 218 deaths occurred. Score distribution was 0\/1\/2 points in 592 (66.8%)\/257 (29.0%)\/37 (4.2%). OS was clearly separated across groups (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001): median OS was not reached for score 0 during follow\u2010up; it was 49.0 months for score 1, and 37.3 months for score 2. In complete cases (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009869; deaths = 211), hazard ratios versus score 0 were 2.16 (95% confidence interval [CI] 1.62\u20132.87) for score 1 and 3.08 (95% CI 1.87\u20135.08) for score 2 (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The PS\u2013Metastatic Burden score showed superior performance (AIC 2513.2; C\u2010index 0.600) compared with CHAARTED and LATITUDE; adding PS to those frameworks improved performance modestly but remained inferior. Upfront androgen receptor pathway inhibitor (ARPI) use was lower in ECOG PS\u2009\u2265\u20091 than PS 0 (38.4% vs 60.8%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and best supportive care initiation or death increased stepwise across score groups (21.3%, 37.2%, 51.4%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A two\u2010factor bedside score integrating host reserve and aggressive metastatic burden provides pragmatic prognostic stratification for real\u2010world mHSPC in the upfront ARPI era and offers information beyond CHAARTED\/LATITUDE. External validation is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70171","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T10:37:39Z","timestamp":1774953459000},"page":"997-1005","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Two\u2010Factor Bedside Prognostic Score Integrating Eastern Cooperative Oncology Group (ECOG) Performance Status and Aggressive Metastatic Burden in Metastatic Hormone\u2010Sensitive Prostate Cancer"],"prefix":"10.1002","volume":"86","author":[{"given":"Koichiro","family":"Kurokawa","sequence":"first","affiliation":[{"name":"Department of Urology Kimitsu Chuo Byoin Kisarazu Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Urology Kimitsu Chuo Byoin Kisarazu Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0070-1590","authenticated-orcid":false,"given":"Yasutaka","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Urology Chiba University Graduate School of Medicine Chiba Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kodai","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Urology Chiba University Graduate School of Medicine Chiba Chiba 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 Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinpei","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Urology Chiba University Graduate School of Medicine Chiba Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Yoshikawa","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuo","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ko","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Takatsuki Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Arai","sequence":"additional","affiliation":[{"name":"Department of Urology Chiba Rosai Hospital Ichihara Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6516-2519","authenticated-orcid":false,"given":"Hiroaki","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Urology Chibaken Saiseikai Narashino Hospital Narashino Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Higuchi","sequence":"additional","affiliation":[{"name":"Department of Urology Funabashi Municipal Medical Center Funabashi Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinori","family":"Takei","sequence":"additional","affiliation":[{"name":"Department of Urology Chiba University Graduate School of Medicine Chiba Chiba 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