Prostate-Specific Antigen Kinetics under Androgen Deprivation Therapy and Prostate Cancer Prognosis

Objectives: To compare the difference in characteristics of post-treatment prostate-specific antigen (PSA) kinetics among respective patients and their influence on disease prognosis. Methods: A cohort of totally 332 eligible patients with histologically confirmed and hormonally naive prostate cancer, identified from the patients' database of Huashan Hospital, all received combined androgen deprivation therapy including bilateral orchiectomy or luteinizing hormone-releasing hormone antagonists with the oral administration of flutamide 250 mg t.i.d. All patients had their serum PSA level tested at least every 3 months in the first 2 years and at least once a half year from the third year on. PSA nadir, time to PSA nadir (TTPN), PSA normalization (<4 ng/ml), undetectable PSA level (<0.2 ng/ml), biochemical failure, overall survival and cancer-specific survival were analyzed. Results: PSA normalization, TTPN, and reaching the undetectable PSA level perhaps were the independent risk factors for predicting the three types of prognosis. Probably the best cutoff of PSA nadir was 0.2 ng/ml (sensitivity 65.7%, specificity 80.6%) and the best cut-off of TTPN was 10 months (sensitivity 71.6%, specificity 63.9%). Conclusions: These results implied that a lower level of PSA nadir and longer TTPN can predict a better disease prognosis. Copyright (c) 2013 S. Karger AG, Basel