Objectives: The role of the tumor growth fraction has been investigated poorly in metastatic castration-resistant prostate cancer (mCRPC). The aim of this study was to assess whether some prostate-specific antigen (PSA)-related variables of tumor cell kinetics predict the overall survival in early and late mCRPC, and to explore changes in the tumor growth fraction after chemotherapy. Methods: A retrospective analysis of 3 tumor cell kinetic variables in patients with mCRPC receiving first-line chemotherapy has been performed. The PSA-related tumor growth rate, the log ratio, and the tumor response have been measured at 3 different times. A further analysis has been performed after stratification by the Gleason score and chemotherapy. Finally, tumor growth after progression to chemotherapy has been explored. Results: G at castration resistance is significantly associated with survival after chemotherapy among patients with a low Gleason score (r=−0.650, P-value=0.022). At the time of first-line chemotherapy, both G and PSA response rates report a significant relationship with survival. At the time of postchemotherapy progression, only the G after 12 weeks of chemotherapy maintains a relationship with survival in patients with a low Gleason score (r=−0.483, P-value=0.023); in particular, a tumor growth rate
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