Serum prostate-specific antigen and survival after external beam radiotherapy for carcinoma of the prostate.
OBJECTIVE
To evaluate the significance of pretreatment prostate-specific antigen (pPSA) levels as a predictor of overall survival simultaneously with previously established prognostic factors. The pPSA level is a major predictor of treatment failure after radiotherapy and surgery, but to date has not been shown to predict survival.


METHODS
This analysis was based on data from 927 patients with clinically localized prostate cancer treated with radiotherapy alone between 1987 and 1998. These patients were stratified into four prognostic risk groups, and multivariate analysis was used to determine the independent impact of pPSA level on PSA failure, progression-free survival (death from any cause after PSA failure), and overall survival (death from any cause).


RESULTS
In a multivariate analysis simultaneously considering the prognostic risk group, a pPSA level greater than or equal to 20 ng/mL was associated with a higher risk of PSA failure and worse progression-free and overall survival.


CONCLUSIONS
The pPSA level is an independent predictor of survival in patients initially treated with radiotherapy alone.
Roach
Mack
M
Department of Radiation Oncology, University of California, San Francisco, School of Medicine, 94143-1708, USA.
Weinberg
Vivian
V
McLaughlin
Patrick W
PW
Grossfeld
Gary
G
Sandler
Howard M
HM
D000230:Adenocarcinoma / Q000097:blood* / Q000401:mortality / Q000532:radiotherapy*; D000368:Aged; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000401:mortality / Q000532:radiotherapy*; D020266:Radiotherapy, Conformal / Q000379:methods*; D016019:Survival Analysis; D017211:Treatment Failure
D017430:Prostate-Specific Antigen