Clinical Significance of Free-to-Total Prostate-Specific Antigen (PSA) Ratio in Advanced Prostate Cancer Patients with PSA Less than 0.1 ng/ml after Hormone Treatment.
10.4111/kju.2012.53.3.149
- Author:
Dae Il KIM
1
;
Jae Mann SONG
;
Hyun Chul CHUNG
Author Information
1. Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea. chc7174@yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Hormone replacement therapy;
Prostate-specific antigen;
Prostatic neoplasms
- MeSH:
Follow-Up Studies;
Hormone Replacement Therapy;
Humans;
Kaplan-Meier Estimate;
Lymph Nodes;
Medical Records;
Neoplasm Metastasis;
Prognosis;
Prostate;
Prostate-Specific Antigen;
Prostatic Neoplasms;
Retrospective Studies
- From:Korean Journal of Urology
2012;53(3):149-153
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We analyzed the pattern of change in the free-to-total prostate-specific antigen (f/t PSA) ratio and the progression to castration-resistant prostate cancer (CRPC) in patients with advanced prostate cancer who received hormone treatment and whose PSA nadir was below 0.1 ng/ml. MATERIALS AND METHODS: We retrospectively analyzed the medical records of 52 patients with advanced prostate cancer. All patients were treated with maximum androgen blockade (gonadotrophin-releasing hormone agonist and anti-androgen agents). The patients were divided into two groups: those with a nadir f/t PSA ratio above 60% and those with a nadir f/t PSA ratio of 60% or below. Age, initial PSA, clinical stage, lymph node metastasis, bone metastasis, and follow-up data, including PSA, free PSA, and f/t PSA ratio, were collected. The Mann-Whitney U-test, Fisher exact test, chi-square test, Kaplan-Meier survival analysis, and log rank test were used. RESULTS: There were 24 patients in the group with a nadir f/t PSA ratio above 60% and 28 patients in the group with a nadir f/t PSA ratio of 60% or below. After hormone therapy, the median f/t PSA ratio in each group increased from 37% and 34% at 3 months to 75% and 60% at 6 months, respectively. At 9 months, however, the f/t PSA ratio increased to 80% in the group with a nadir f/t PSA ratio above 60%, whereas it decreased to 31% in the group with a nadir f/t PSA ratio of 60% or below. From 9 to 15 months, the f/t PSA ratio showed a tendency to decrease (75 to 37% and 27 to 20%, respectively). The progression to CRPC was significantly different between the two groups (10 vs. 24). CONCLUSIONS: Progression to CRPC was significantly higher in the group with a lower f/t PSA ratio. Additionally, the pattern of change in the f/t PSA ratio was significantly different after 9 months. Collectively, the f/t PSA ratio can be used as an additional marker for prognosis of hormone treatment.
