Failing to achieve a nadir prostate-specific antigen after combined androgen blockade: Predictive factors
Failing to achieve a nadir prostate-specific antigen after combined androgen blockade: Predictive factors
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DOI：
10.1111/j.1442-2042.2009.02329.x
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发表时间：
2009-08-01
影响因子：
2.6
通讯作者：
Yoon, Jin Han
中科院分区：
文献类型：
--
作者：
Park, Seung Chol;Rim, Joung Sik;Yoon, Jin Han
目的：确定最低点前列腺特异性抗原（PSA）预测联合雄激素阻断（CAB）后24个月内进展的最佳截止值，并分析未能达到最低点PSA的预测因素。方法：我们回顾性分析了2000年至2005年343例接受CAB治疗的前列腺癌患者的病历。我们确定了预测CAB后24个月进展为激素难治性前列腺癌（HRPC）的最低PSA水平。未能达到确定的最低PSA的预测因素进行了analysed.Results：平均年龄为74.0岁。平均随访42.1个月。77例患者进展为HRPC。PSA最低值1.0 ng/mL预测24个月时进展为HRPC。在单变量分析中，未能达到最低PSA 1.0 ng/mL或更低的预测因素包括治疗前PSA、阳性活检针百分比、Gleason评分、血清血红蛋白、分期和骨转移程度。Logistic回归分析显示，治疗前PSA（> 50 ng/mL）和血清血红蛋白（<12 g/dL）是预测未达到最低PSA 1.0 ng/mL或更低的重要因素。结论：最低PSA 1.0 ng/mL可预测CAB后进展为HRPC。治疗前PSA和血清血红蛋白是未能达到PSA最低值1.0 ng/mL或更低的重要预测因素。
Objectives:To determine the optimal cut-off of a nadir prostate-specific antigen (PSA) for prediction of progression within 24 months after combined androgen blockade (CAB) and to analyze predictive factors of failing to achieve the nadir PSA.Methods:We retrospectively reviewed the medical records of 343 patients with prostate cancer treated with CAB from 2000 to 2005. We determined the nadir PSA level that predicts progression to hormone refractory prostate cancer (HRPC) at 24 months after CAB. Predictive factors for failing to achieve a determined nadir PSA were analyzed.Results:Mean age was 74.0 years. Mean follow up was 42.1 month. Seventy-seven patients experienced progression to HRPC. A nadir PSA of 1.0 ng/mL predicts progression to HRPC at 24 months. Predictive factors for failing to achieve a nadir PSA of 1.0 ng/mL or less include pretreatment PSA, percentage positive biopsy core, Gleason score, serum hemoglobin, stage, and extent of bone metastasis in univariate analysis. Pretreatment PSA (> 50 ng/mL) and serum hemoglobin (< 12 g/dL) were significant factors to predict failing to achieve a nadir PSA of 1.0 ng/mL or less in logistic regression analysis.Conclusions:A nadir PSA of 1.0 ng/mL can predict progression to HRPC after CAB. Pretreatment PSA and serum hemoglobin are significant predictors of failing to achieve a nadir PSA of 1.0 ng/mL or less.