Response of prostate-specific antigen after androgen withdrawal and prognosis in men with metastatic prostate cancer.
OBJECTIVE
Patients with prostate cancer generally respond to androgen withdrawal therapy, but progression to androgen independence is frequently observed. To evaluate prognostic factors in metastatic prostate cancer, patients who had been treated with endocrine therapy were investigated.


METHODS
One hundred and thirty-nine patients with untreated metastatic prostate cancer (TxNxM1) who received endocrine therapy between 1986 and 1993 were included in the present study. Blood chemistry, histological grade, extent of bony metastases, clinical response to hormone therapy, and the prognosis of the patients were evaluated.


RESULTS
With univariate analysis, performance status, hemoglobin concentration, serum alkaline phosphatase, lactate dehydrogenase, histological grade, extent of bony disease, and response of prostate-specific antigen (PSA) at 3 months were shown to be significant prognostic factors. With multivariate analyses, response of PSA and histological grade were significant factors predicting prognosis.


CONCLUSIONS
Patients whose PSA had not normalized 3 months after the start of endocrine therapy were in the high-risk group, and should be given more aggressive treatment.
Furuya
Y
Y
Department of Urology, Chiba University, School of Medicine, Asahi General Hospital, Chiba, Japan.
Akimoto
S
S
Akakura
K
K
Igarashi
T
T
Murakami
S
S
Shimazaki
J
J
Ito
H
H
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000728:Androgens / Q000008:administration & dosage*; D001774:Blood Chemical Analysis; D001859:Bone Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary*; D002715:Chlormadinone Acetate / Q000008:administration & dosage; D004054:Diethylstilbestrol / Q000008:administration & dosage; D005485:Flutamide / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood / Q000187:drug effects*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate
D000728:Androgens; D002715:Chlormadinone Acetate; D004054:Diethylstilbestrol; D005485:Flutamide; D017430:Prostate-Specific Antigen