The prognostic importance of prostate specific antigen in the monitorisation of patients undergoing maximum androgen blockade for metastatic prostate cancer.
BACKGROUND
The changes in serum prostate specific antigen (PSA) concentrations can be used as a prognostic factor in patients undergoing maximum androgen blockade for metastatic prostate cancer.


METHODS
A total of 149 patients followed up in our department were classified into 4 groups on the basis of PSA changes: group 1; those with normalisation of PSA levels within the first 3 months, group 2; those with normalisation PSA between months 3 and 6, group 3; those with a decrease in PSA but not reaching normal range, group 4; those with no decrease. The gleason scores and the number of bone metastases were also compared between the groups.


RESULTS
The time to progression was significantly delayed in group 1 (mean: 23.3 months) compared to those with group 2 (mean: 16.9 months) (P<0.02). The time to progression in group 3 (mean: 8.45 months) was significantly shorter compared to the first two groups (P<0.001). Also, in patients with gleason scores 5-7 (grades 2) and gleason scores over 7 (grade 3) and group 1, the time to progression (mean: 21.2 months) was significantly delayed compared to those with the same gleason scores but with group 2 (mean: 13.4 months) (P<0.001).


CONCLUSIONS
The decrease in PSA level is more important than gleason scores in determining the time to progression. Early normalisation of PSA delays the time to progression, and when combined with gleason scores, PSA is an important prognostic factor in predicting the success of the therapy.
Kiper
Ahmet
A
1st Department of Urology, Ankara SSK Hospital, Ankara, Turkey.
Yiğitbasi
Orhan
O
Imamoglu
Abdurrahim
A
Tuygun
Can
C
Turan
Celaleddin
C
D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009362:Neoplasm Metastasis; D009919:Orchiectomy; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies
D018931:Antineoplastic Agents, Hormonal; D017273:Goserelin; D017430:Prostate-Specific Antigen; D016729:Leuprolide