Clinical Significance and Evaluation for Nadir PSA Level after ADT for Prostate Cancer
10.3969/j.issn.1001-1420.2009.07.011
- VernacularTitle:前列腺癌ADT治疗期间PSA最低值的评估及临床意义
- Author:
YANG KUN
1
;
WANG HUI
;
ZHANG FENG
;
JIANG YU
Author Information
1. 上海市杨浦区中心医院
- Keywords:
prostate cancer;
androgen-deprived therapy;
PSA
- From:
Journal of Clinical Urology
2009;24(7):512-514,519
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical value of nadir PSA level after ADT for prostate cancer. Mcth-ods:Reviewed clinical data of patients with prostate cancer treated with bilateral orchiectomy between June 1999 and June 2007. The patient swere divided into two groups based on whether nadir PSA level after ADT decreased to 0.2 ng/ml, and were made multivariate analysis. Results:71 patients with a mean age of 76.0 years old (range 56 to 90) treated with bilateral orchiectomy were included in this study. Mean follow-up was 43.9±27.8 months. 45 patients (63.4%) presented with nadir PSA level ≤0. 2 ng/ml,and 26 (36.6%) >0.2 ng/ml. There were sig-nificant difference in mean nadir PSA levels between the two groups (P<0.002). The interval until PSA level reached nadir after ADT was similar (P>0.5). However ≤0.2 ng/ml group provided a longer period free of na-dir PSA level progression than >0.2 ng/ml group(P<0.05). Of the ≤0.2 ng/ml group the 5-year cumulative PSA progression-free survival was higher than >0.2 ng/ml group significantly (log-rank test, χ2= 8.68, P< 0.005), the clinical progression rate (22%) in PSA level lower than the >0.2 ng/ml group (50%) (χ2= 5.80, P <0.025), overall survival time (48.4 months) longer than the >0.2 ng/ml group(33.1 months) (t=2.22,P< 0.05). In patients died of prostate cancer a mean survival time for ≤0.2 ng/ml group(58.2 months) was longer than >0.2 ng/ml group(19.8 months) (t= 6.29 P<0.001). Conclusions: The nadir PSA level after ADT may be an important predictor of the sensitive degree for ADT in patients with prostate cancer. The lower nadir PSA level is a better prognostic factor of prostate cancer. Patients whose nadir PSA level after ADT could not reach 0.2 ng/ ml have a higher risk of biochemical and clinical progress.
