A novel nomogram based on serum lipid for identifying the patients at risk for rapid progression of advanced hormone-sensitive prostate cancer

Background Serum lipids were reported to be significant predictive factors in various tumors. In order to develop and validate a nomogram for predicting castration-resistant prostate cancer (CRPC) free survival in advanced hormone-sensitive prostate cancer (HSPC) patients, the goal of this study was to assess the prognostic impact of the lipid profiles. Material and Methods The follow-up information of 146 CRPC patients who received androgen deprivation therapy as the first and only therapy before progression were retrospectively examined. To evaluate prognostic variables, univariate and multivariate Cox regression analyses were used. The concordance index (C-index), calibration curves, receiver operating characteristic (ROC) curves, and decision curve analyses (DCA) were used to design and evaluate a novel nomogram model. Results Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (apoB), N stage and Gleason sum were determined to be independent prognostic markers and were combined to create a nomogram. This nomogram performed well in the customized prediction of CRPC development at 6th, 12th, 18th and 24th month. The C-indexes in training and validation sets were 0.740 and 0.755, respectively. ROC curves, calibration plots, and DCA all suggested favorable discrimination and predictive ability. Besides, the nomogram also performed better predictive ability than N stage and Gleason sum. The Nomogram-related risk score divided the patient population into two groups with significant progression disparities. Conclusions The established nomogram could aid in identifying the patients at high risk for rapid progression of advanced HSPC, so as to formulate individualized therapeutic regimens and follow-up strategies in time. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was supported by the “1+X” program for Clinical Competency enhancement-Clinical Research Incubation Project and the Second Hospital of Dalian Medical University (2022LCYJZD02) to B.Y. the cultivating scientific research project of the Second Hospital of Dalian Medical University (dy2yynpy202217) to Y.B the cultivating scientific research project of the Second Hospital of Dalian Medical University (dy2yynpy202220) to Y.Z. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The research protocol was accepted by the ethical committee of the Second Hospital of Dalian Medical University (number: 2023064) with the Declaration of Helsinki I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data analyzed during the current study are available from the corresponding author on reasonable request.