Evaluation of Bellmunt Risk Score as a prognostic score in metastatic-castration resistant prostate cancer

Metastatic castration-resistant prostate cancer (mCRPC) is an aggressive, incurable and often lethal condition. It is characterized by two factors: A prostate cancer (a type of cancer that forms in the prostate gland) which has spread beyond the prostate, forming so-called metastases. Moreover, the cancer no longer responds to anti-hormonal treatment, a therapy that aims to inhibit or block the production/effects of certain hormones in the body, and therefore requires further therapy. In a western population, about 6 in 1000 men suffer from mCRPC and approximately 2 in 1000 men are newly diagnosed per year.

Patients often want information about how long they will survive with this disease given their individual life plans or family and relationship bounds. Therefore, we aim to provide patients and their doctors an easy tool to predict the survival times.
The so-called Bellmunt Risk Score looks at the three factors: overall health status, blood count (hemoglobin) levels, and whether the cancer has spread to the liver. A score of 0 - 3 can quickly be built only from these factors.

In a small study involving 125 men with mCRPC, we already found that the Bellmunt Risk Score could be useful in predicting survival. While men with a score of 0 lived for approximately 4 years, men with scores larger than 2 only lived for about one year. With overall health status collected more accurate, a modified Bellmunt Risk score even improved these predictions. However, we need proof for these findings in studies with larger groups of patients.

We aim at extracting Bellmunt Risk Score and survival times from the data of large controlled studies. We want to discover, if we can confirm our previous findings. This is possible by comparing the survival times of men with each score of 0, 1, 2 and 3 using the established statistical tools "Cox regression analysis" and "Log-Rank analysis". If we find significant differences between these groups, this score could become a valuable tool for doctors and patients, helping them to be informed and make better decisions about treatment.

转移性去势抵抗性前列腺癌（Metastatic castration-resistant prostate cancer, mCRPC）是一种侵袭性强、无法治愈且通常致命的恶性疾病。其核心特征包含两点：其一，前列腺癌（一种起源于前列腺腺体的恶性肿瘤）已突破前列腺包膜，形成所谓的转移灶；其二，该肿瘤不再对抗激素治疗（anti-hormonal treatment）产生应答——此类治疗旨在抑制或阻断体内特定激素的生成与作用，因此患者需接受后续抗肿瘤治疗。在西方人群中，每1000名男性中约有6人罹患mCRPC，每年每1000名男性中约有2人被新诊断为该病。

患者往往希望结合自身人生规划、家庭与社交关系，了解罹患该病后的生存时长。因此我们旨在为患者及其主治医师提供一款简便易用的生存预测工具。

所谓的贝尔蒙特风险评分（Bellmunt Risk Score）涵盖三项评估因素：整体健康状况、血常规（血红蛋白）水平，以及肿瘤是否已发生肝转移。仅通过这三项因素即可快速生成0至3分的评分结果。

在一项纳入125名mCRPC患者的小型临床研究中，我们已证实贝尔蒙特风险评分可有效预测患者生存情况：评分为0的患者中位生存期约为4年，而评分大于2的患者中位生存期仅约1年。若能更精准地收集整体健康状况数据，改良版贝尔蒙特风险评分甚至可进一步提升预测效能。不过，我们仍需在更大规模的患者队列研究中验证上述发现。

本研究旨在从大型对照研究的数据中提取贝尔蒙特风险评分与患者生存时间数据，以验证我们此前的研究结论。具体可通过采用公认的统计学工具"Cox回归分析（Cox regression analysis）"与"对数秩分析（Log-Rank analysis）"，对比评分为0、1、2、3的各组患者的生存时间来实现。若能证实各组患者的生存时长存在显著差异，该评分或将成为临床医师与患者的实用工具，助力双方充分知情并制定更合理的治疗决策。