Luteinizing hormone-releasing hormone agonist monotherapy for prostate cancer: outcome and prognostic factors.
BACKGROUND
We assessed the outcome and prognostic factors in men with prostate cancer after luteinizing hormone-releasing hormone agonist monotherapy.


METHODS
Between April 1998 and August 2002, 62 men with prostate cancer who were treated with monotherapy at our institution were included in this analysis. Prostate-specific antigen (PSA) failure-free (bNED) survival was calculated using Kaplan-Meier methods. Prognostic factors were evaluated using Cox proportional hazards regression model.


RESULTS
We reviewed the data of patients, with a median follow-up from the commencement of monotherapy of 26 months. The overall survival rate at 3 years was 89.9%. The bNED survival rate was 63.7% at 3 years. Of the 20 patients with clinical stage B, 2 progressed to PSA failure, whereas PSA failure was seen in 8 of 30 patients with stage C and 8 of 12 patients with stage D. The significant factors for bNED status were an initial PSA level of <30 ng/ml (p=0.0044), achievement of PSA nadir level of <2.0 ng/ml (p<0.001), and Gleason score of <or=6 (p<0.001).


CONCLUSIONS
Patients with high clinical stage, a high initial PSA level of >or=30 ng/ml, and high Gleason score of >or=7 are at increased risk for PSA failure. Failure to achieve PSA nadir level of <2.0 ng/ml is an important predictor of the progression. The use of PSA nadir can provide useful guidelines for the reconsideration of treatment in patients who have received monotherapy.
Kiriyama
Isao
I
Department of Urology, Nippon Medical School, Tokyo, Japan. kiriyama@nms.ac.jp
Kimura
Go
G
Kondo
Yukihiro
Y
Saito
Yuka
Y
Kimata
Ryoji
R
Suzuki
Yasutomo
Y
Nishimura
Taiji
T
D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome
D007987:Gonadotropin-Releasing Hormone; D017430:Prostate-Specific Antigen