Prostate-specific antigen kinetic profiles during androgen deprivation therapy as prognostic factors in castration-resistant prostate cancer.
OBJECTIVE
To identify pretreatment prognostic factors for patients with castration-resistant prostate cancer (CRPC) undergoing docetaxel (DCT) chemotherapy.


METHODS
We retrospectively analyzed 102 patients with CRPC who underwent DCT chemotherapy (dosage: 60-75 mg/m(2)) from December 2001 to August 2013. The parameters evaluated as prognostic factors were as follows: age, body mass index, Gleason score, clinical TNM stage, prior radical prostatectomy, prior radiation therapy, performance status, presence of pain, laboratory results at the start of DCT, and prostate-specific antigen (PSA) kinetics during prior androgen deprivation therapy (ADT), including PSA level at the start of ADT (PSA-ADT), PSA half-time (PSAT1/2), time to nadir, PSA level at nadir (PSA-Nadir), duration of nadir, PSA doubling time (PSADT), and PSA level at the start of DCT (PSA-DCT). Univariate and multivariate analyses were performed to identify independent prognostic factors.


RESULTS
Median cancer-specific survival (CSS) duration following CRPC diagnosis was 28.0 months. In univariate analyses, performance status, serum albumin, serum creatinine, PSAT1/2, time to nadir, PSA-Nadir, duration of nadir, PSADT, and PSA-DCT showed a potential association with prognosis (P<0.001-0.077). Multivariate analyses of these parameters showed that performance status (hazard ratio [HR] = 0.046; P = 0.046), serum creatinine (HR = 3.028; P = 0.036), PSAT1/2 (HR = 0.172; P = 0.007), PSA-Nadir (HR = 4.884; P = 0.033), PSADT (HR = 0.148; P<0.001), and PSA-DCT (HR = 5.222; P = 0.004) remained independent predictors of CSS in CRPC.


CONCLUSIONS
PSA kinetic parameters measured during prior ADT are significant surrogate markers predicting CSS in patients undergoing DCT chemotherapy for CRPC.
Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
Myong
M
Kim
Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
Junghoon
J
Lee
Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
Chang Wook
CW
Jeong
Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
Ja Hyeon
JH
Ku
Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
Hyeon Hoe
HH
Kim
Department of Urology, Seoul National University College of Medicine, Seoul, Korea. Electronic address: mdrafael@snu.ac.kr.
Cheol
C
Kwak
D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011379:Prognosis; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies
D000726:Androgen Antagonists
Cancer-specific survival; Castration-resistant prostate cancer; Prediction model; Prognostic factor; Prostate-specific antigen kinetics