The study aimed to assess the value of circulating tumor cells (CTCs) as a prognostic and treatment response marker in patients undergoing androgen deprivation therapy (ADT) plus cryosurgery vs. ADT alone for metastatic prostate cancer (mPCA). This retrospective analysis included 43 patients with mPCA: 23 receiving ADT alone (control) and 20 receiving additional cryosurgery (cryosurgery group). CTCs and progression-free survival (PFS) were compared between the two groups. Cox proportional hazards regression was conducted to identify variables associated with PFS. Median PFS was 35 months (IQR, 33‑37) in the cryosurgery group vs. 30 months (IQR, 27‑32) in the control (p < 0.001). CTCs count was significantly lower in the cryosurgery group at both 3 months (z = 2.170, p = 0.030) and 12 months (z = 2.481; p = 0.013). In comparison to the baseline, the number of CTCs at both 3 and 12 months was lower in the cryosurgery group (p = 0.004 and p < 0.001, respectively), but not in the ADT alone group. In multivariate Cox regression, shorter PFS was associated with baseline PSA ≧100 ng/ml (HR 6.584, 95% CI, 5.309‑8.166), biopsy Gleason score ≧ 8 (HR 2.064, 95% CI, 1.608‑2.650), clinic T stage>T2b (HR 5.021, 95% CI, 3.925‑6.421), number of bone metastases>3 (HR 3.421, 95% CI, 2.786‑4.202), positive CTCs at 3 months post-treatment (HR 6.833, 95% CI, 5.176‑9.022), positive CTCs 1 year post-treatment (HR 6.051, 95% CI, 4.347‑8.424). Prostate cryosurgery was associated with longer PFS (HR 0.062, 95% CI, 0.048‑.080). CTC was a prognostic and treatment response marker for mPCA. ADT plus cryosurgery could reduce CTCs and prolong PFS vs. ADT alone in mPCA patients with low metastatic volume.

中文翻译：

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接受雄激素剥夺治疗的转移性前列腺癌患者接受与不接受冷冻手术的循环肿瘤细胞：回顾性分析

该研究旨在评估循环肿瘤细胞 (CTC) 作为接受雄激素剥夺疗法 (ADT) 加冷冻手术与单独 ADT 治疗转移性前列腺癌 (mPCA) 的患者的预后和治疗反应标志物的价值。该回顾性分析包括 43 名 mPCA 患者：23 名仅接受 ADT（对照），20 名接受额外的冷冻手术（冷冻手术组）。比较两组的 CTC 和无进展生存期 (PFS)。进行 Cox 比例风险回归以识别与 PFS 相关的变量。冷冻手术组的中位 PFS 为 35 个月（IQR，33-37），而对照组为 30 个月（IQR，27-32）（p < 0.001）。在 3 个月（z = 2.170，p = 0.030）和 12 个月（z = 2.481；p = 0.013）时，冷冻手术组的 CTC 计数显着降低。与基线相比，冷冻手术组在 3 个月和 12 个月时的 CTC 数量均较低（分别为 p = 0.004 和 p < 0.001），但在单独 ADT 组中并非如此。在多变量 Cox 回归中，较短的 PFS 与基线 PSA ≥100 ng/ml (HR 6.584, 95% CI, 5.309‑8.166)、活检 Gleason 评分 ≧ 8 (HR 2.064, 95% CI, 1.608‑2.650) 相关分期>T2b（HR 5.021，95% CI，3.925-6.421），骨转移数量>3（HR 3.421，95% CI，2.786-4.202），治疗后 3 个月 CTC 阳性（HR 6.833，95% CI） , 5.176-9.022)，治疗后 1 年 CTC 阳性（HR 6.051，95% CI，4.347-8.424）。前列腺冷冻手术与更长的 PFS 相关（HR 0.062，95% CI，0.048-.080）。CTC 是 mPCA 的预后和治疗反应标志物。在低转移体积的 mPCA 患者中，与单独使用 ADT 相比，ADT 加冷冻手术可以减少 CTC 并延长 PFS。