Prostate-specific Antigen Nadir and Time to Prostate-specific Antigen Nadir Following Maximal Androgen Blockade Independently Predict the Prognosis in Patients with Metastatic Prostate Cancer

PURPOSE: To evaluate the influence of prostate-specific antigen (PSA) kinetics following maximal androgen blockade (MAB) on the disease progression and cancer-specific survival in patients with metastatic, hormone sensitive prostate cancer. MATERIALS AND METHODS: One hundred thirty-one patients with metastatic, hormone sensitive prostate cancer treated with MAB at our institution were included in this study. Patients’ characteristics, PSA level at MAB initiation, PSA nadir, time to PSA nadir (TTN), and PSA decline were analyzed by using univariate and multivariate analysis. RESULTS: At a median follow-up of 30 months, 97 patients (74.0%) showed disease progression and 65 patients (49.6%) died. Fifty-nine patients (45.0%) died from prostate cancer. On univariate analysis, PSA at MAB initiation, PSA nadir, TTN, and PSA decline were significant predictors of progression-free survival. And PSA nadir, TTN, and PSA decline were significant predictors of cancer-specific survival. On multivariate analysis, higher PSA nadir (≥0.2 ng/ml) and shorter TTN (<8 months) were independent predictors of shorter progression-free and cancer-specific survivals. In the combined analysis of PSA nadir and TTN, patients with higher PSA nadir and shorter TTN had the worst progression-free survival (hazard ratio 14.098, p<0.001) and cancer-specific survival (hazard ratio 14.050, p<0.001) compared to those with lower PSA nadir and longer TTN. CONCLUSIONS: Our results suggest that higher PSA nadir level and shorter TTN following MAB are associated with higher risk of disease progression and poorer survival in patients with metastatic, hormone sensitive prostate cancer. Furthermore, these two variables have synergistic effect on the patients’ outcome.

Author dc:creator

• 홍, 석영

Contributors dc:contributor

• 김, 세중
• 대학원 의학과
• 201024571

• Prognosis
• Prostatic neoplasms
• Prostate-specific antigen
• 예후
• 전립성 종양
• 전립성특이항원

Language dc:language

en

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000013655
000000013655

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/8637