title: Association of time to prostate-specific antigen nadir and logarithm of prostate-specific antigen velocity after progression in metastatic prostate cancer with prior primary androgen deprivation therapy.
abstract: We investigated the association of time to prostate-specific antigen nadir (TTPN) and logarithm of prostate-specific antigen velocity after progression Log(PSAVAP) in metastatic prostate cancer with prior primary androgen deprivation therapy (ADT). All metastatic prostate cancer patients treated with primary ADT from 2000 to 2009 were reviewed. Patients who developed disease progression were included in the subsequent analyses. Patients were categorized into three groups according to their TTPN: TTPN of <3 months, 3-17 months, and >17 months. We compared the Log(PSAVAP) between the different TTPN groups using Mann-Whitney U-test and Kruskal-Wallis test. Further multiple linear regression analyses on Log(PSAVAP) were performed to adjust for other potential confounding factors. Among 419 patients who were treated with primary ADT, 306 patients developed disease progression with a median follow-up of 28 months. Longer TTPN was associated with lower Log(PSAVAP) (P = 0.008) within all subgroup analyses (TTPN of <3 vs 3-17 months, P= 0.020; TTPN of 3-17 vs >17 months, P= 0.009; and TTPN of <3 vs >17 months, P= 0.001). Upon multiple linear regression analyses, baseline PSA (regression coefficient 0.001, P= 0.045), PSA nadir (regression coefficient 0.002, P= 0.040), and TTPN (regression coefficient -0.030, P= 0.001) were the three factors that were significantly associated with Log(PSAVAP). In conclusion, a longer TTPN was associated with lower Log(PSAVAP) in metastatic prostate cancer patients following primary ADT. TTPN cut-offs at 3 months and 17 months appeared to have prognostic significance in predicting Log(PSAVAP). TTPN may serve as a good prognostic indicator in deciding the treatment strategy in patients with disease progression.
authors.affiliation: Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.
authors.forename: Jeremy Yc
authors.initials: JY
authors.lastname: Teoh
authors.affiliation: Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: James Hl
authors.initials: JH
authors.lastname: Tsu
authors.affiliation: Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Steffi Kk
authors.initials: SK
authors.lastname: Yuen
authors.affiliation: Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.
authors.forename: Peter Kf
authors.initials: PK
authors.lastname: Chiu
authors.affiliation: Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.
authors.forename: Samson Ys
authors.initials: SY
authors.lastname: Chan
authors.affiliation: Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Ka-Wing
authors.initials: KW
authors.lastname: Wong
authors.affiliation: Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Kwan-Lun
authors.initials: KL
authors.lastname: Ho
authors.affiliation: Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.
authors.forename: Simon Sm
authors.initials: SS
authors.lastname: Hou
authors.affiliation: Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.
authors.forename: Chi-Fai
authors.initials: CF
authors.lastname: Ng
authors.affiliation: Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Ming-Kwong
authors.initials: MK
authors.lastname: Yiu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000813:Anilides / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000378:metabolism* / Q000556:secondary; D015331:Cohort Studies; D017373:Cyproterone Acetate / Q000627:therapeutic use; D018450:Disease Progression; D005047:Etoposide / Q000627:therapeutic use; D005485:Flutamide / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D007610:Kallikreins / Q000378:metabolism*; D007654:Ketoconazole / Q000627:therapeutic use; D008297:Male; D009362:Neoplasm Metastasis; D009570:Nitriles / Q000627:therapeutic use; D009919:Orchiectomy; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000378:metabolism*; D011471:Prostatic Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D013997:Time Factors; D014105:Tosyl Compounds / Q000627:therapeutic use
chemical_list: D000726:Androgen Antagonists; D000813:Anilides; D000970:Antineoplastic Agents; D009570:Nitriles; D014105:Tosyl Compounds; D007987:Gonadotropin-Releasing Hormone; D017373:Cyproterone Acetate; D005047:Etoposide; D005485:Flutamide; C053541:bicalutamide; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen; D007654:Ketoconazole