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

Abstract 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.