约翰·霍普金斯大学的数据充分记录了延迟激素治疗引起的生化复发 (BCR) 的自然史。然而，由于许多患者在转移前接受治疗，我们在一组更现代的患有非转移性去势敏感前列腺癌 (nmCSPC) 的 BCR 患者中评估了前列腺特异性抗原倍增时间 (PSADT) 的自然史和作用。退伍军人健康管理局（VHA；01/01/06 至 06/22/20）将 nmCSPC 和 BCR 分为快速（≤ 9 个月）和较慢（≥ 9 至 ≤ 15 个月）PSADT 队列。 PSADT≥15 个月的患者被排除在外，因为即使延迟治疗，结果也很好。结果包括 BCR 后首次抗肿瘤治疗的时间、转移、无转移生存期 (MFS) 和总生存期 (OS)。 Cox 模型根据基线人口统计和临床特征进行调整。总体而言，确定了 781 名 BCR 患者（502 名快速患者；279 名较慢的 PSADT）。快速 PSADT 与首次全身抗肿瘤治疗时间较短（中位时间 11.4 个月与 28.3 个月，调整后风险比 [95% 置信区间] 2.17 [1.83-2.57]）、转移（102.4 个月与未达到，1.79 [1.33-]）相关。 2.40]）、MFS（76.1 vs. 106.3 个月，1.73 [1.33-2.24]）和 OS（120.5 vs. 140.5 个月，1.76 [1.22-2.54]）与较慢的 PSADT 相比。大多数快速 PSADT 患者在BCR 后 1 年。更多接受早期二级治疗的当代患者比延迟治疗患者的历史数据有更好的结果。这些结果是否反映了早期二级治疗的益处或随着时间的推移前列腺癌结果的整体改善，需要进一步研究。© 2024。作者。

The natural history of biochemical recurrence (BCR) managed with delayed hormonal therapy is well documented by data from Johns Hopkins. However, as many patients receive treatment prior to metastasis, we evaluated the natural history and role of prostate-specific antigen doubling time (PSADT) in a more contemporary cohort of BCR patients with nonmetastatic castration-sensitive prostate cancer (nmCSPC).Patients in the Veterans Health Administration (VHA; 01/01/06 to 06/22/20) with nmCSPC and BCR were divided into rapid ( ≤9 months) and less rapid ( >9 to ≤15 months) PSADT cohorts. Patients with PSADT >15 months were excluded as outcomes, even with delayed treatment, are excellent. Outcomes included time to first antineoplastic therapy after BCR, metastasis, metastasis-free survival (MFS), and overall survival (OS). Cox models adjusted for baseline demographics and clinical characteristics.Overall, 781 patients with BCR were identified (502 rapid; 279 less rapid PSADT). Rapid PSADT was associated with shorter time to first systemic antineoplastic therapy (median 11.4 vs. 28.3 months, adjusted hazard ratio [95% confidence interval] 2.17 [1.83-2.57]), metastasis (102.4 months vs. not reached, 1.79 [1.33-2.40]), MFS (76.1 vs. 106.3 months, 1.73 [1.33-2.24]), and OS (120.5 vs. 140.5 months, 1.76 [1.22-2.54]) versus less rapid PSADT.Most patients with rapid PSADT underwent secondary treatment within 1 year after BCR. More contemporary patients treated with early secondary treatment had better outcomes than historical data from patients who had delayed treatment. Whether these results reflect the benefits of early secondary treatment or overall improvements in prostate cancer outcomes over time requires further study.© 2024. The Author(s).