{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T13:39:40Z","timestamp":1793281180333,"version":"4.5.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:p>\n                    This multicenter retrospective study assessed real-world treatment patterns and outcomes in\n                    <jats:italic toggle=\"yes\">de novo<\/jats:italic>\n                    metastatic hormone-sensitive prostate cancer (mHSPC) across five urological centers in Hong Kong (China; from 2016 to 2023). Of 3308 patients, 814 (24.6%) presented with\n                    <jats:italic toggle=\"yes\">de novo<\/jats:italic>\n                    mHSPC. High-volume and high-risk disease were present in 59.1% and 53.8% of patients, respectively. Despite guidelines favoring intensified therapy, androgen deprivation therapy (ADT) monotherapy remained the most common treatment (52.0%), while only 28.7% received upfront chemotherapy (20.5%) or androgen receptor pathway inhibitors (ARPI; 8.2%). During a median 40-month follow-up period, 48.4% of patients died and 60.1% progressed to castration-resistant prostate cancer (CRPC) within a median of 19 months. Five-year overall survival rates were highest for ARPI (64.9%), followed by chemotherapy (53.5%) and monotherapy (38.7%), with corresponding 5-year CRPC-free survival rates of 73.5%, 7.7%, and 15.0%, respectively. Upfront chemotherapy and ARPI demonstrated significant reductions in cancer-specific mortality compared to ADT monotherapy (chemotherapy hazard ratio [HR]: 0.58, 95% confidence interval [CI]: 0.41\u20130.82,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.002; ARPI HR: 0.32, 95% CI: 0.17\u20130.62,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001). High-volume disease (HR: 2.14, 95% CI: 1.52\u20133.01,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001) and ISUP Grade 4 or 5 (HR: 5.70, 95% CI: 1.82\u201317.87,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.003) conferred increased risk. Upfront chemotherapy and ARPI were independently associated with improved overall survival (chemotherapy HR: 0.56, 95% CI: 0.41\u20130.78,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001; ARPI HR: 0.41, 95% CI: 0.24\u20130.69,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001). High-volume mHSPC (HR: 1.65, 95% CI: 1.24\u20132.21,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001) and ISUP Grade 4 or 5 (HR: 2.38, 95% CI: 1.22\u20134.65,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.011) were significant adverse prognostic factors. Advanced age at diagnosis was associated with increased all-cause mortality (HR: 1.02, 95% CI: 1.00\u20131.03,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.037). These findings highlight an urgent need to improve adoption of intensified treatment strategies for optimal patient outcomes.\n                  <\/jats:p>","DOI":"10.4103\/aja202616","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:00:10Z","timestamp":1784120410000},"page":"766-772","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Disease characteries, treatment patterns, and oncological outcomes of de novo metastatic hormone-sensitive prostate cancer: real-world experience from a multicenter Asian cohort"],"prefix":"10.4103","volume":"28","author":[{"given":"Ivan Ching-Ho","family":"Ko","sequence":"first","affiliation":[{"name":"SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China"},{"name":"Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin Cheuk Kin","family":"Cheng","sequence":"additional","affiliation":[{"name":"SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China"},{"name":"Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris Ho-Ming","family":"Wong","sequence":"additional","affiliation":[{"name":"SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China"},{"name":"Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joycelyn Yung Yung","family":"Lim","sequence":"additional","affiliation":[{"name":"SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China"},{"name":"Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candice Hiu Tung","family":"Mok","sequence":"additional","affiliation":[{"name":"SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China"},{"name":"Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheuk Yi","family":"Tang","sequence":"additional","affiliation":[{"name":"SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China"},{"name":"Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian Chun Fai","family":"Kwok","sequence":"additional","affiliation":[{"name":"SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China"},{"name":"Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Hong","family":"Zhou","sequence":"additional","affiliation":[{"name":"SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Ho","family":"Leung","sequence":"additional","affiliation":[{"name":"SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy Sau Kwan","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tuen Mun Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph Kai Man","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Surgery, Pok Oi Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Fai","family":"Ng","sequence":"additional","affiliation":[{"name":"SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China"},{"name":"Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China"},{"name":"Department of Surgery, North District Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"R2-20261029","doi-asserted-by":"crossref","first-page":"2931","DOI":"10.1002\/cncr.31384","article-title":"Trends in incidence and 5-year mortality in men with newly diagnosed, metastatic prostate cancer-a population-based analysis of 2 national cohorts","volume":"124","author":"Helgstrand","year":"2018","journal-title":"Cancer"},{"key":"R3-20261029","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.eururo.2021.05.016","article-title":"Overall survival of men with metachronous metastatic hormone-sensitive 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