title: Prognostic value of neuroendocrine serum markers and PSA in irradiated patients with pN0 localized prostate cancer.
abstract: BACKGROUND
  The prognosis of patients with localized prostate cancer depends on clinical stage, histological grade, and pretreatment prostate-specific antigen (PSA). We evaluated the additional prognostic impact of serum levels of neuron-specific enolase (NSE) and chromograninA (CgA) after curative radiotherapy and the importance of serum PSA, analyzed 3 months after irradiation.
  
  
  METHODS
  From 1988 to 1995, 161 patients with localized T1-4, pN0M0, prostate adenocarcinoma were treated with external radiation (66Gy, 2Gy/5 fractions per week). Frozen serum samples were assessed for CgA, NSE, and PSA before and 3 months after radiotherapy. CgA was analyzed in only 100 patients. NSE and CgA were determined by a immunometric assay. Total PSA was measured by a time-resolved fluoro-immunometric assay.
  
  
  RESULTS
  Prior to radiotherapy CgA was elevated in 16 of 100 patients, and NSE was elevated in 33 of the 161 patients. There was no association between grade, T category or pretreatment PSA and the levels of neuroendocrine markers. Pretreatment-elevated serum NSE, but not initial CgA, identified patients with an unfavorable prognosis. A < 50% reduction of PSA 3 months after radiotherapy was associated with decreased failure-free 10 years urvival. Multivariate analysis demonstrated an increased risk of failure for patients with elevated pretreatment NSE and PSA values, T3 category, and decline of PSA less than 50% 3 months after radiotherapy. The presence of none or several risk factors (1-4) defined clearly separable groups.
  
  
  CONCLUSIONS
  Together with T category and pretreatment serum PSA values, serum NSE values before radiotherapy and decrease of serum PSA 3 months after radiotherapy represent easily assessable prognostic parameters in patients undergoing curative radiation treatment for prostate cancer.
authors.affiliation: Department of Oncology and Radiotherapy, Norwegian Radium Hospital, N-0310 Oslo, Norway. wolfgang.lilleby@klinmed.uio.no
authors.forename: W
authors.initials: W
authors.lastname: Lilleby
authors.forename: E
authors.initials: E
authors.lastname: Paus
authors.forename: E
authors.initials: E
authors.lastname: Skovlund
authors.forename: S D
authors.initials: SD
authors.lastname: Fosså
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000276:immunology / Q000532:radiotherapy; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D053379:Chromogranin A; D002864:Chromogranins / Q000097:blood*; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000276:immunology / Q000473:pathology / Q000532:radiotherapy
chemical_list: D014408:Biomarkers, Tumor; D053379:Chromogranin A; D002864:Chromogranins; D017430:Prostate-Specific Antigen; D010751:Phosphopyruvate Hydratase