title: [Survival is associated with time to reach PSA nadir (DAN) and the ratio DAN/nadir value after androgen deprivation for prostate cancer].
abstract: OBJECTIVE
  The objective of this study was to assess the prognostic decrease rate of PSA in patients treated with androgen suppression (AS) for prostate cancer (PCa).
  
  
  METHODS
  We identified in our database CaP patients with histologically documented, treated with SA alone and for whom vital status with a minimum follow-up of 6 months (except death beforehand) was established. Patient characteristics and CaP and PSA at baseline, PSA nadir, time of reaching the nadir PSA (DAN) and the ratio of the DAN/nadir value (ratio DAN/Nadir) were analyzed in relation to progression-free survival, specific and overall survival.
  
  
  RESULTS
  One hundred ninety eight patients met the inclusion criteria and the median was 61.5 months (range 4.8 to 233). The median PSA at the start of the SA were 37.1 ng/mL and the median nadir PSA was 0.48 ng/mL. The median time to progression was 23.6 months. The median specific and overall survivals were 94 and 78 months, respectively. In univariate analysis, predictors of progression-free survival were PSA before SA, PSA nadir, DAN, DAN ratio/nadir, Gleason score, the percentage of core positive prostate biopsy and the status of bone scintigraphy. Except for PSA before SA which was no longer significant, predictors of specific and overall survival were similar and added the biochemical response (decrease of more than 50% of PSA) to a second hormonal manipulation during the biological progression. In multivariate analysis, the nadir PSA and the ratio DAN/Nadir remained significant predictors.
  
  
  CONCLUSIONS
  These results have confirmed in one hand the predictive value of survival in patients DAN SA for CaP: achieving faster nadir PSA was associated with shorter survival. They have introduced in the other hand the new concept of DAN/Nadir PSA which provides independent prognostic information.
authors.affiliation: Service d'urologie, CHU La Milétrie, 2, rue de la Milétrie, 86000 Poitiers, France.
authors.forename: A
authors.initials: A
authors.lastname: Gagnat
authors.forename: S
authors.initials: S
authors.lastname: Larré
authors.forename: G
authors.initials: G
authors.lastname: Fromont
authors.forename: C
authors.initials: C
authors.lastname: Pirès
authors.forename: B
authors.initials: B
authors.lastname: Doré
authors.forename: J
authors.initials: J
authors.lastname: Irani
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D015996:Survival Rate; D013997:Time Factors
chemical_list: D000726:Androgen Antagonists; D017430:Prostate-Specific Antigen