Portal de Periódicos da CAPES

Prostate Specific Antigen Half-Time and Prostate Specific Antigen Doubling Time as Predictors of Response to Androgen Deprivation Therapy for Metastatic Prostate Cancer

2009; Lippincott Williams & Wilkins; Volume: 181; Issue: 6 Linguagem: Inglês

10.1016/j.juro.2009.01.104

1527-3792

Yong Hyun Park, In Sik Hwang, Chang Wook Jeong, Hyeon Hoe Kim, Sang Eun Lee, Cheol Kwak,

Hepatitis B Virus Studies

No AccessJournal of UrologyAdult Urology1 Jun 2009Prostate Specific Antigen Half-Time and Prostate Specific Antigen Doubling Time as Predictors of Response to Androgen Deprivation Therapy for Metastatic Prostate Cancer Yong Hyun Park, In Sik Hwang, Chang Wook Jeong, Hyeon Hoe Kim, Sang Eun Lee, and Cheol Kwak Yong Hyun ParkYong Hyun Park More articles by this author , In Sik HwangIn Sik Hwang More articles by this author , Chang Wook JeongChang Wook Jeong More articles by this author , Hyeon Hoe KimHyeon Hoe Kim More articles by this author , Sang Eun LeeSang Eun Lee More articles by this author , and Cheol KwakCheol Kwak More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2009.01.104AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined the clinical significance of prostate specific antigen half-time and prostate specific antigen doubling time after the prostate specific antigen nadir as predictors of the response to androgen deprivation therapy for metastatic prostate cancer. Materials and Methods: A total of 131 patients with metastatic prostate cancer treated with androgen deprivation were included in this analysis. Clinicopathological features and cancer specific survival were compared among the patients who were divided according to prostate specific antigen half-time and prostate specific antigen doubling time after the prostate specific antigen nadir. Results: Median followup was 53.0 months. Baseline and nadir prostate specific antigen did not differ between the patients with a short prostate specific antigen half-time (1 month or less) and those with a long prostate specific antigen half-time (longer than 1 month). Patients with a short prostate specific antigen half-time had a higher Gleason score, shorter nadir duration and shorter cancer specific survival. No differences were found between the patients with a short (6 months or less) and those with a long (longer than 6 months) prostate specific antigen doubling time after the prostate specific antigen nadir in terms of baseline prostate specific antigen, nadir prostate specific antigen, biopsy Gleason score and prostate specific antigen half-time. A short prostate specific antigen doubling time after the prostate specific antigen nadir was associated with shorter nadir duration and poorer median cancer specific survival. On multivariate analysis Gleason score, nadir prostate specific antigen and prostate specific antigen half-time remained independent predictors of an increase in prostate specific antigen after androgen deprivation therapy. Nadir prostate specific antigen, prostate specific antigen half-time and prostate specific antigen doubling time after the prostate specific antigen nadir were prognostic factors for cancer specific survival. Conclusions: The results of our study suggest that prostate specific antigen half-time and prostate specific antigen doubling time after the prostate specific antigen nadir are independent prognostic indicators for an increase in prostate specific antigen after androgen deprivation therapy and cancer related death in patients with metastatic prostate cancer treated with androgen deprivation. References 1 : Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med2004; 351: 1502. Google Scholar 2 : Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. N Engl J Med2004; 351: 1513. Google Scholar 3 : Nomogram for overall survival of patients with progressive metastatic prostate cancer after castration. J Clin Oncol2002; 20: 3972. Google Scholar 4 : Prognostic model for predicting survival in men with hormone-refractory metastatic prostate cancer. J Clin Oncol2003; 21: 1232. Google Scholar 5 : Studies on prostatic cancer: I. The effect of castration, of estrogen and androgen injection on serum phosphatases in metastatic carcinoma of the prostate. CA Cancer J Clin1972; 22: 232. Google Scholar 6 : Prognostic significance of prostate specific antigen in endocrine treatment for prostatic cancer. J Urol1990; 144: 1415. Link, Google Scholar 7 : Prostatic specific antigen and the prediction of prognosis in metastatic prostatic cancer. Cancer1990; 66: 1025. Google Scholar 8 : Prostate specific antigen and Gleason grade: an immunohistochemical study of prostate cancer. J Urol1994; 151: 1558. Link, Google Scholar 9 : Independent prognostic role of circulating chromogranin A in prostate cancer patients with hormone-refractory disease. Endocr Relat Cancer2005; 12: 109. Google Scholar 10 : Androgen-mediated resistance to apoptosis. Prostate2002; 53: 300. Google Scholar 11 : New concepts in radiation-induced apoptosis: ‘premitotic apoptosis’ and ‘postmitotic apoptosis’. J Cell Mol Med2001; 5: 240. Google Scholar 12 : Defining biochemical cure for prostate carcinoma patients treated with external beam radiation therapy. Cancer1999; 86: 1557. Google Scholar 13 : PSA nadir predicts biochemical and distant failures after external beam radiotherapy for prostate cancer: a multi-institutional analysis. Int J Radiat Oncol Biol Phys2006; 64: 1140. Google Scholar 14 : Prostate specific antigen nadir following external beam radiation therapy for clinically localized prostate cancer: the relationship between nadir level and disease-free survival. J Urol1996; 156: 450. Link, Google Scholar 15 : Posttreatment prostate-specific antigen nadir highly predictive of distant failure and death from prostate cancer. Int J Radiat Oncol Biol Phys2002; 53: 297. Google Scholar 16 : Prostate cancer radiation dose response: results of the M. D. Anderson phase III randomized trial. Int J Radiat Oncol Biol Phys2002; 53: 1097. Google Scholar 17 : Natural history of progression after PSA elevation following radical prostatectomy. JAMA1999; 281: 1591. Google Scholar 18 Maximum androgen blockade in advanced prostate cancer: an overview of 22 randomised trials with 3283 deaths in 5710 patients: Prostate Cancer Trialists' Collaborative Group. Lancet1995; 346: 265. Google Scholar 19 Maximum androgen blockade in advanced prostate cancer: an overview of the randomised trials: Prostate Cancer Trialists' Collaborative Group. Lancet2000; 355: 1491. Google Scholar 20 : Systematic review and meta-analysis of monotherapy compared with combined androgen blockade for patients with advanced prostate carcinoma. Cancer2002; 95: 361. Google Scholar Department of Urology, Seoul National University Hospital, Seoul, Korea© 2009 by American Urological AssociationFiguresReferencesRelatedDetails Volume 181Issue 6June 2009Page: 2520-2525 Advertisement Copyright & Permissions© 2009 by American Urological AssociationKeywordsdrug therapyprostatic neoplasmsprostate-specific antigenMetricsAuthor Information Yong Hyun Park More articles by this author In Sik Hwang More articles by this author Chang Wook Jeong More articles by this author Hyeon Hoe Kim More articles by this author Sang Eun Lee More articles by this author Cheol Kwak More articles by this author Expand All Advertisement PDF downloadLoading ...