title: Prostate-specific antigen doubling time and survival in patients with advanced metastatic prostate cancer.
abstract: The relation between tumor kinetics and disease progression in patients with hormone-refractory prostate cancer (HRPC) has not been well described. Biochemical recurrence of prostate cancer is characterized by detectable prostate-specific antigen (PSA) levels after treatment and occurs in approximately 30% of patients after therapy for apparent localized disease. An increase in PSA almost always occurs before clinical evidence of disease. The ability to identify early biochemical failure in patients to assess disease aggressiveness and guide changes in treatment needs to be examined. We examined serial PSA data from 249 patients with metastatic disease to assess PSA doubling time (PSADT) in hormone-naive prostate cancer (HNPC) and HRPC states. In a subset of patients, the relation of PSADT to Gleason score and survival was studied. PSADT decreased from 37.5 +/- 4.5 weeks to 15.6 +/- 1.6 weeks (mean +/- SEM) in patients with HNPC versus HRPC. In this small study, PSADT did not correlate with Gleason score, survival from start of hormonal treatment, length of time receiving hormone therapy, or survival in the HRPC state. The decrease in PSADT with disease state may help provide insight into understanding the biology of late-stage disease.
authors.affiliation: Department of Medicine, Michigan Urology Center, University of Michigan, Ann Arbor, Michigan 48109-0946, USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Loberg
authors.forename: Jeffery R
authors.initials: JR
authors.lastname: Fielhauer
authors.forename: Brian A
authors.initials: BA
authors.lastname: Pienta
authors.forename: Scott
authors.initials: S
authors.lastname: Dresden
authors.forename: Patty
authors.initials: P
authors.lastname: Christmas
authors.forename: Linda M
authors.initials: LM
authors.lastname: Kalikin
authors.forename: Karin B
authors.initials: KB
authors.lastname: Olson
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Pienta
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009363:Neoplasm Proteins / Q000097:blood*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D012306:Risk; D016879:Salvage Therapy; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D009363:Neoplasm Proteins; D017430:Prostate-Specific Antigen