Prognostic Value of Serial Serum Prostate-Specific Antigen Measurements in Metastatic Prostate Cancer Patients Treated with Androgen Ablation

血中前列腺特異抗原變化在接受男性荷爾蒙去除療法的轉移前列腺癌患者的預後意義

蔡育賢(Yuh-Shyan Tsai) ； 蔡宗欣(Tzong-Shin Tzai) ； 林信男(Johnny Sn Lin) ； 唐一清(Yat-Ching Tong) ； 楊文宏(Wen-Horng Yang) ； 張建成(Chien-Chen Chang) ； 鄭鴻琳(Hong-Lin Cheng) ； 林永明(Yung-Ming Lin)

《臺灣泌尿科醫學會雜誌》 16卷2期 (2005/06) Pp. 65-73

摘要

Objective: To evaluate the prognostic value of changes in prostate-specific antigen (PSA) on the outcome of patients with metastatic prostate cancer treated with androgen ablation.
Patients and Methods: We analyzed 6 pretreatment clinicopathological and 5 posttreatment PSA parameters in 39 advanced prostate cancer patients receiving androgen ablation. Their ages ranged from 50 to 84 (mean, 67.8) years, and they were regularly followed up for 12 to 96 (mean, 27.9) months.
Results: Univariate analysis revealed that (1) a patient's age of ＞65 years, (2) a PSA drop to ≤4ng/ml within 3 months (i.e., a return to normal), (3) a PSA nadir value of ＜1ng/ml, and (4) a duration of PSA of ≤4ng/ml of longer than 12 months were 4 significant prognostic indicators for the disease-specific overall survival (p＜0.05), whereas the pretreatment PSA value, PSA half-life, and PSA doubling time were not. Further analysis with the multivariate Cox proportional hazard models revealed that a duration of PSA normalization of longer than 12 months was the strongest indicator of a favorable outcome. Moreover, patients with a PSA nadir value of ＜1ng/ml had significant longer normalization periods but not PSA doubling times compared to those who had a PSA nadir value of between 1 and 4ng/ml.
Conclusions: Results of this study reveal that (1) an age of ≥65 years, (2) a drop in the PSA value to ≤4ng/ml within 3 months, (3) a PSA nadir value of ＜1ng/ml, and (4) a PSA normalization duration of ＞12 months were the 4 significant prognostic parameters of metstatic prostate cancer patients treated with androgen ablation. In general, the lower the PSA nadir value a patient is able to achieve the longer the PSA normalization period and eventually a better disease-specific survival he may enjoy.

關鍵字

前列腺癌 ； 前列腺特異抗原 ； 男性荷爾蒙去除療法

並列摘要

Objective: To evaluate the prognostic value of changes in prostate-specific antigen (PSA) on the outcome of patients with metastatic prostate cancer treated with androgen ablation.
Patients and Methods: We analyzed 6 pretreatment clinicopathological and 5 posttreatment PSA parameters in 39 advanced prostate cancer patients receiving androgen ablation. Their ages ranged from 50 to 84 (mean, 67.8) years, and they were regularly followed up for 12 to 96 (mean, 27.9) months.
Results: Univariate analysis revealed that (1) a patient's age of ＞65 years, (2) a PSA drop to ≤4ng/ml within 3 months (i.e., a return to normal), (3) a PSA nadir value of ＜1ng/ml, and (4) a duration of PSA of ≤4ng/ml of longer than 12 months were 4 significant prognostic indicators for the disease-specific overall survival (p＜0.05), whereas the pretreatment PSA value, PSA half-life, and PSA doubling time were not. Further analysis with the multivariate Cox proportional hazard models revealed that a duration of PSA normalization of longer than 12 months was the strongest indicator of a favorable outcome. Moreover, patients with a PSA nadir value of ＜1ng/ml had significant longer normalization periods but not PSA doubling times compared to those who had a PSA nadir value of between 1 and 4ng/ml.
Conclusions: Results of this study reveal that (1) an age of ≥65 years, (2) a drop in the PSA value to ≤4ng/ml within 3 months, (3) a PSA nadir value of ＜1ng/ml, and (4) a PSA normalization duration of ＞12 months were the 4 significant prognostic parameters of metstatic prostate cancer patients treated with androgen ablation. In general, the lower the PSA nadir value a patient is able to achieve the longer the PSA normalization period and eventually a better disease-specific survival he may enjoy.

並列關鍵字

prostatic neoplasm ； prostatic-specific antigen ； androgen ablation