Nadir prostate-specific antigen best predicts the progression to androgen-independent prostate cancer
Nadir prostate-specific antigen best predicts the progression to androgen-independent prostate cancer
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DOI：
10.1002/ijc.11639
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发表时间：
2004-03-01
影响因子：
6.4
通讯作者：
Reventos, J
中科院分区：
文献类型：
--
作者：
Morote, J;Trilla, E;Reventos, J
本研究的目的是分析前列腺特异性抗原（PSA）水平在雄激素抑制前后的价值，以预测晚期和转移性前列腺癌患者的雄激素非依赖性进展（AIP）时间。对283名接受雄激素抑制作为单一治疗的前列腺癌患者进行了研究。98例患者为局部晚期，其余185例为转移性。AIP定义为血清PSA在最低值后连续2次升高。AIP前的平均随访时间为29.2个月（3-198）。205例患者（72.4%）检测到AIP。152例患者（74.1%）在24个月内检测到事件，而53例患者（25.9%）在24个月后观察到事件。多变量分析显示，最低PSA和达到最低PSA的时间是至AIP时间的最显著预测因素。PSA ≤ 0.2 ng/mL的患者生化反应超过24个月的优势比高20倍，而雄激素抑制后PSA最低值超过12个月的患者优势比高18倍。这些结果表明，达到不可检测的最低PSA的能力和达到最低PSA的时间是雄激素抑制单药治疗的局部晚期和转移性前列腺癌患者至AIP时间的最重要预测因素。(C)2003 Wiley-Liss，Inc.
The objective of our study was to analyze the value of prostate-specific antigen (PSA) levels before and after androgen suppression to predict the time to androgen-independent progression (AIP) in patients with advanced and metastatic prostate cancer. A series of 283 prostate cancer patients under androgen suppression as a single treatment was studied. The disease was locally advanced in 98 patients and metastatic in the remainder 185. AIP was defined after 2 consecutive increases of serum PSA after the nadir value. The mean follow-up before AIP was 29.2 months (3-198). AIP was detected in 205 patients (72.4%). In 152 patients (74.1%), the event was detected within 24 months, while in 53 patients (25.9%), it was observed beyond 24 months. The multivariate analysis showed that the nadir PSA and the time to reach the nadir PSA were the most significant predictors of the time to AIP. The odds ratio of having a biochemical response greater than 24 months was 20 times higher in patients that achieved an undetectable PSA level of 0.2 ng/mL or less. Moreover in those patients whose nadir PSA reached beyond 12 months after androgen suppression the odds ratio was 18 times higher. These results show that the ability to achieve an undetectable nadir PSA and the time to reach it are the most significant predictors of the time to AIP in patients with locally advanced and metastatic prostate cancer under androgen suppression as a single therapy. (C) 2003 Wiley-Liss, Inc.