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.
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.
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DOI：
10.4103/1008-682x.164921
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发表时间：
2017-01
影响因子：
2.9
通讯作者：
Yiu MK
中科院分区：
文献类型：
--
作者：
Teoh JY;Tsu JH;Yuen SK;Chiu PK;Chan SY;Wong KW;Ho KL;Hou SS;Ng CF;Yiu MK
我们研究了转移性前列腺癌既往原发性雄激素剥夺治疗（ADT）患者的前列腺特异性抗原最低点（TTPN）时间与进展后前列腺特异性抗原速度对数（PSAVAP）的关系。回顾了2000年至2009年所有接受原发性ADT治疗的转移性前列腺癌患者。出现疾病进展的患者被纳入随后的分析。根据TTPN情况将患者分为TTPN <3个月、TTPN <3 - 17个月、TTPN < 17个月三组。采用Mann-Whitney u检验和Kruskal-Wallis检验比较不同TTPN组间的Log（PSAVAP）。进一步对Log（PSAVAP）进行多元线性回归分析，以调整其他潜在的混杂因素。在419例接受原发性ADT治疗的患者中，306例患者在28个月的中位随访期间出现疾病进展。在所有亚组分析中，较长的TTPN与较低的Log（PSAVAP）相关（TTPN <3 vs 3 - 17个月，P = 0.020; TTPN <3 vs >17个月，P = 0.009; TTPN <3 vs >17个月，P = 0.001）。在多元线性回归分析中，基线PSA（回归系数0.001,P = 0.045）、PSA最低点（回归系数0.002,P = 0.040）和TTPN（回归系数- 0.030,P = 0.001）是与Log（PSAVAP）显著相关的三个因素。总之，原发性ADT后转移性前列腺癌患者较长的TTPN与较低的Log（PSAVAP）相关。3个月和17个月的TTPN截断值对预测Log（PSAVAP）具有预后意义。TTPN可作为决定疾病进展患者治疗策略的良好预后指标。
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.