{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T06:31:50Z","timestamp":1775025110026,"version":"3.50.1"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The incidence and prognosis of synchronous bone-metastatic hormone-sensitive prostate cancer (SBM-HSPC) in contemporary China remain unclear. This study aimed to determine its current prevalence, characterize patient profiles, and identify independent prognostic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of patients with SBM-HSPC diagnosed at a major tertiary center in China (2017-2023). Demographic, clinicopathological, treatment, and outcome data were analyzed. Overall survival (OS) was evaluated using Kaplan-Meier and Cox regression. A landmark analysis (3- and 6-month) was employed to assess the association between early treatment initiation and OS, mitigating immortal time bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The incidence of SBM-HSPC was 6.09%. The cohort presented with high-risk features: 93.1% had Gleason score \u22658,and 83.7% had high-volume disease (HVD). The median OS was 43 months. Multivariate analysis identified HVD as an independent risk factor (HR\u00a0=\u00a02.37, P\u00a0=\u00a00.012) and age 60\u201374 years as protective (HR\u00a0=\u00a00.52, P\u00a0=\u00a00.040) compared to age &amp;lt;60. Landmark analysis demonstrated that initiation of novel hormonal agents (NHA) within 3 months was associated with a 45% reduction in mortality risk (HR\u00a0=\u00a00.55, P&amp;lt;0.001), an association sustained at 6 months. In contrast, early use of docetaxel or bone-targeting agents was not associated with improved OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The incidence of SBM-HSPC in this Chinese cohort aligns with data from developed healthcare systems. HVD is a key prognostic determinant. Early initiation of NHA therapy is strongly associated with a significant survival benefit, underscoring the critical need for timely, intensive systemic treatment in this high-risk patient population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1719338","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T04:30:38Z","timestamp":1775017838000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Initiation of novel hormonal therapy is associated with improved survival in synchronous bone-metastatic hormone-sensitive prostate cancer: a retrospective cohort study from China"],"prefix":"10.3389","volume":"16","author":[{"given":"Yize","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Urology, The Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, 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