Prognostic factors of advanced prostatic carcinoma.
Eighty-two patients with advanced prostatic carcinoma were treated with a long-acting luteinizing hormone releasing hormone (LHRH) agonist (Zoladex depot, Zeneca Pharmaceuticals, England). The outcome of the treatment was monitored on the basis of the following prognostic factors: local stage, number of bone metastases, histological differentiation grade and prostate-specific acid phosphatase (PAP), alkaline phosphatase (AF) and testosterone levels. The patients were followed-up until disease progression or until death. The mean weight of the prostate decreased from 48.1 g to 17.4 g (P < 0.00001) during the first year of treatment. Statistically there was a significant difference in regard to appearance of progression between different clinical stages (P < 0.00001). The prognosis was poorest in patients with more than 10 metastases at the primary stage. If the PAP level was initially higher (over 20 micrograms/L), the prognosis was very poor. Statistically there was a significant difference between the high PAP level and the slightly elevated or normal PAP (P < 0.02 and P < 0.005, respectively). Alkaline phosphatase (AF) appeared to be a good prognostic factor. The prognosis was particularly poor, if the AF level exceeded 1000 U/L (P < 0.00001 and P < 0.05, compared with normal AP and slightly elevated AP level, respectively). Surprisingly, a high pre-treatment testosterone level worsened the prognosis during the LHRH agonist treatment (P < 0.01, compared to patients with normal testosterone level). This is a new finding and controversial to the findings reported before.
Lukkarinen
O
O
Department of Surgery, Oulu University Central Hospital, Finland.
Lehikoinen
K
K
D000135:Acid Phosphatase / Q000097:blood; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001859:Bone Neoplasms / Q000556:secondary; D005500:Follow-Up Studies; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D015993:Life Tables; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D011467:Prostate / Q000201:enzymology / Q000473:pathology; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D013739:Testosterone / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome
D017273:Goserelin; D013739:Testosterone; D000469:Alkaline Phosphatase; D000135:Acid Phosphatase