{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:14:07Z","timestamp":1779358447209,"version":"3.51.4"},"reference-count":20,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: We aimed to evaluate the prognostic significance of bone pain at presentation in metastatic castration-sensitive prostate cancer (mCSPC) and its association with radiographic progression-free survival (rPFS), independent of established prognostic factors. Methods: We retrospectively analyzed 205 patients with mCSPC treated at our center. Data were obtained from patient files and hospital records. rPFS was estimated using the Kaplan\u2013Meier method and compared using the log-rank test. Baseline characteristics according to bone pain status were compared using the \u03c72 test for categorical variables and the Wilcoxon test for continuous variables. Results: Median rPFS for the entire cohort was 23.8 months (95% CI: 18.6\u201329.0). In univariate analysis, median rPFS was significantly shorter in patients with bone pain compared to those without (16.9 vs. 29.5 months, p &lt; 0.001). Other factors associated with worse rPFS included ECOG PS \u2265 1, DNA repair mutations, high disease volume, liver metastasis, hemoglobin &lt; 12 g\/dL, and albumin &lt; 3.5 g\/dL. In multivariate analysis, bone pain (HR = 2.37, 95% CI: 1.29\u20134.34; p = 0.005), albumin &lt; 3.5 g\/dL (HR = 1.99; p = 0.034), hemoglobin &lt; 12 g\/dL (HR = 2.00; p = 0.005), and liver metastasis (HR = 3.07; p = 0.024) remained independent predictors of shorter rPFS. Conclusions: Bone pain at presentation is an independent prognostic factor for shorter rPFS and may help guide risk stratification and treatment decisions in mCSPC.<\/jats:p>","DOI":"10.3390\/jcm15103968","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T09:29:58Z","timestamp":1779355798000},"page":"3968","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bone Pain Is Associated with Short Radiographic Progression-Free Survival in Patients with Metastatic Castration-Sensitive Prostate Cancer"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4312-724X","authenticated-orcid":false,"given":"Aykut","family":"\u00d6zmen","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, Istanbul 34480, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8879-8533","authenticated-orcid":false,"given":"Caner","family":"Kapar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Bakirk\u00f6y Research and Education Hospital, Istanbul 34140, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1998-3150","authenticated-orcid":false,"given":"\u0130lkay","family":"G\u00fclt\u00fcrk","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Istanbul Research and Education Hospital, Istanbul 34098, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sel\u00e7uk","family":"\u015eahin","sequence":"additional","affiliation":[{"name":"Urology Department, Istinye University, Istanbul 34010, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamil G\u00f6khan","family":"\u015eeker","sequence":"additional","affiliation":[{"name":"Urology Department, Istinye University, Istanbul 34010, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Volkan","family":"Tu\u011fcu","sequence":"additional","affiliation":[{"name":"Urology Department, Istinye University, Istanbul 34010, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deniz","family":"Tural","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ko\u00e7 University Hospital, Istanbul 34010, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2544","DOI":"10.1200\/JCO.2007.15.0367","article-title":"Pain predicts overall survival in men with metastatic castration-refractory prostate cancer","volume":"26","author":"Halabi","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1111\/j.1464-410X.2008.08283.x","article-title":"What is the real impact of bone pain on survival in patients with metastatic hormone-refractory prostate cancer treated with docetaxel?","volume":"103","author":"Oudard","year":"2009","journal-title":"BJU Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2736","DOI":"10.1200\/JCO.22.02661","article-title":"External validation of a prognostic model of overall survival in men with chemotherapy-na\u00efve metastatic castration-resistant prostate cancer","volume":"41","author":"Halabi","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2200","DOI":"10.1093\/annonc\/mdy406","article-title":"Development and validation of a prognostic model for overall survival in chemotherapy-na\u00efve men with metastatic castration-resistant prostate cancer","volume":"29","author":"Armstrong","year":"2018","journal-title":"Ann. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.eururo.2014.09.022","article-title":"Prognostic factors for survival in noncastrate metastatic prostate cancer: Validation of the Glass model and development of a novel simplified prognostic model","volume":"68","author":"Gravis","year":"2015","journal-title":"Eur. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e2419966","DOI":"10.1001\/jamanetworkopen.2024.19966","article-title":"Bone pain and survival among patients with metastatic, hormone-sensitive prostate cancer: A secondary analysis of the SWOG-1216 trial","volume":"7","author":"Gabriela","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1056\/NEJMoa1503747","article-title":"Chemohormonal therapy in metastatic hormone-sensitive prostate cancer","volume":"373","author":"Sweeney","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1200\/JCO.2015.64.2702","article-title":"Trial design and objectives for castration-resistant prostate cancer: Updated recommendations from the Prostate Cancer Clinical Trials Working Group 3","volume":"34","author":"Scher","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"ref_9","unstructured":"National Cancer Institute (2024, March 28). Cancer Facts: Prostate Cancer, Available online: https:\/\/seer.cancer.gov\/statfacts\/html\/prost.html."},{"key":"ref_10","unstructured":"National Comprehensive Cancer Network (2024, April 17). Prostate Cancer. Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/prostate.pdf."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1016\/S1470-2045(19)30082-8","article-title":"Abiraterone acetate plus prednisone in patients with newly diagnosed high-risk metastatic castration-sensitive prostate cancer (LATITUDE): Final overall survival analysis of a randomized, double-blind, phase 3 trial","volume":"20","author":"Fizazi","year":"2019","journal-title":"Lancet Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1056\/NEJMoa1704174","article-title":"Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer","volume":"377","author":"Fizazi","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1056\/NEJMoa1702900","article-title":"Abiraterone for prostate cancer not previously treated with hormone therapy","volume":"377","author":"James","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1056\/NEJMoa1903307","article-title":"Apalutamide for metastatic, castration-sensitive prostate cancer","volume":"381","author":"Chi","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/S1470-2045(23)00063-3","article-title":"Testosterone suppression plus enzalutamide versus testosterone suppression plus standard antiandrogen therapy for metastatic hormone-sensitive prostate cancer (ENZAMET): An international, open-label, randomized, phase 3 trial","volume":"24","author":"Sweeney","year":"2023","journal-title":"Lancet Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1016\/S0140-6736(22)00367-1","article-title":"Abiraterone plus prednisone added to androgen deprivation therapy and docetaxel in de novo metastatic castration-sensitive prostate cancer (PEACE-1): A multicentre, open-label, randomised, phase 3 study with a 2\u2009\u00d7\u20092 factorial design","volume":"399","author":"Fizazi","year":"2022","journal-title":"Lancet"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3595","DOI":"10.1200\/JCO.23.00041","article-title":"Darolutamide plus androgen-deprivation therapy and docetaxel in metastatic hormone-sensitive prostate cancer by disease volume and risk subgroups in the phase Phase III ARASENS Trial","volume":"4","author":"Hussain","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1056\/NEJMoa2119115","article-title":"Darolutamide and Survival in Metastatic, Hormone-Sensitive Prostate Cancer","volume":"386","author":"Smith","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/0304-3959(83)90143-4","article-title":"Development of the Wisconsin Brief Pain Inventory to assess pain in cancer and other diseases","volume":"17","author":"Daut","year":"1983","journal-title":"Pain"},{"key":"ref_20","unstructured":"Fayers, P., Aaronson, N.K., Bjordal, K., Groenvold, M., Curran, D., and Bottomley, A. (2001). EORTC QLQ-C30 Scoring Manual, EORTC Quality of Life Department."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/10\/3968\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:04:05Z","timestamp":1779357845000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/10\/3968"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":20,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["jcm15103968"],"URL":"https:\/\/doi.org\/10.3390\/jcm15103968","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]}}}