The purpose of this study was to identify the early predictor of survival for prostate cancer patients with bone metastasis. We reviewed 87 prostate cancer patients with bone metastasis who had received primary androgen deprivation therapy (PADT) at our institution. The medical records of the patients were examined with respect to laboratory data, pathological results, PSA response to PADT and clinical outcome. The overall survival (OS) rates were analyzed with reference to the nadir PSA level and time to PSA nadir (TTN) following PADT by Kaplan-Meier method. In all, 59 patients (67%) had progression to castration-resistant prostate cancer. Nadir PSA o0.2 ng ml -1 (lower PSA nadir) during PADT were observed in 47 patients (54%). Multivariate analysis revealed that the extent of disease on bone scan (P ¼ 0.04), lower PSA nadir following PADT (P ¼ 0.003), albumin (P ¼ 0.04) and lactate dehydrogenase (P ¼ 0.01) were independent prognostic factors for survival. OS rates in the patients with lower PSA nadir were significantly higher. Longer TTN (49 months) identified patients with prolonged OS in both lower and higher PSA nadir groups. PSA nadir o0.2 ng ml -1 and prolonged TTN (49 months) following PADT might be the most important early predictors for longer survival in prostate cancer patients with bone metastasis.

This is the first study to evaluate HRQoL changes (up to 24 weeks) in patients who have undergone RFA or laparoscopic radical nephrectomy for small renal cell carcinoma. No reduction, but rather an improvement, in HRQoL was seen in the RFA group during follow-up periods. From the point of view of QoL, RFA could be a viable alternative treatment for selected patients with small renal cell carcinoma. RFA could be a viable alternative treatment for the selected patients with small renal cell carcinoma.

To identify the early predictor of progression to castration-resistant prostate cancer (CRPC) for different stage of advanced PC patients, we focused on time to prostate-specific antigen (PSA) nadir following primary androgen deprivation therapy (PADT). We reviewed 184 advanced (locally advanced and metastatic) PC patients (101 patients with bone metastasis (BM) and 83 patients without BM at presentation) who had received PADT at our institution. We evaluated laboratory data, pathological results, and the influence of PSA kinetics impact on disease progression. The progression rates were analyzed with reference to the nadir PSA level and time to PSA nadir (TTN) following PADT by Kaplan-Meier method. In all, 103 patients (56%) progressed to CRPC. Nadir PSA lower than 0.2 ng/ml (nadir %0.2) during PADT was observed in 114 patients (62%). Median TTN was 8.5 months in patients with BM and 11.5 months in patients without BM. Multivariate analysis revealed that nadir %0.2 following PADT (P!0.001), longer TTN (O8 months) (P!0.001), extent of disease on bone scan grade (PZ0.02), and T stage (PZ0.04) in BM group and nadir %0.2 following PADT (P!0.001), longer TTN (O11 months) (P!0.001), and T stage (PZ0.03) in without BM group were independent prognostic factors for progression. In both groups, longer TTN identified patients with prolonged progression-free survival in both nadir %0.2 and O0.2 nadir levels. Longer TTN is strongly associated with a low risk of disease progression, and the cutoff value of TTN could be inversely correlated with disease progression.

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