Prognostic Significance of Time to Prostate-Specific Antigen (PSA) Nadir and Its Relationship to Survival Beyond Time to PSA Nadir for Prostate Cancer Patients With Bone Metastases After Primary Androgen Deprivation Therapy

Teoh, Jeremy Yuen‐Chun; Tsu, James Hok‐Leung; Yuen, Steffi Kar Kei; Chan, Symphorosa S. C.; Chiu, Peter Ka Fung; Lee, Wai-Man; Wong, Ka-Wing; Ho, Ka Yan; Hou, See‐Ming; Ng, Chi‐Fai; Yiu, MK

doi:10.1245/s10434-014-4105-8

Cited by 31 publications

(40 citation statements)

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“…As the primary outcome of our study is Log(PSAVAP), only patients who developed disease progression were included for subsequent analyses. We believe that those patients who did not develop disease progression were skewed towards longer TTPN 15. While patients with longer TTPN were associated with lower Log(PSAVAP) as shown in this current study, exclusion of those nonprogressive patients might possibly underpower our study, which however still showed significant results despite such exclusion.…”

Section: Discussionmentioning

confidence: 65%

“…We previously reported the use of survival beyond TTPN as an alternative outcome measurement in a similar cohort including patients without disease progression 15. Using survival beyond TTPN as the primary outcome, the effect of immortal time bias from TTPN on survival can be reduced.…”

Section: Discussionmentioning

confidence: 99%

“…We categorized our cohort into three groups according to their TTPN (TTPN of <3 months, 3–17 months and >17 months) based on our previous analyses on PFS beyond TTPN 15. A longer TTPN was associated with lower Log(PSAVAP) ( P = 0.008) upon Kruskal–Wallis test.…”

Section: Discussionmentioning

confidence: 99%

“…The stratification of TTPN into these three groups was based on our previous finding that the progression-free survival (PFS) beyond TTPN for patients in these three groups were different 15. The Log(PSAVAP) of each TTPN group was presented with Box-and-Whisker plots.…”

Section: Methodsmentioning

confidence: 99%

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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

et al. 2017

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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.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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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

et al. 2017

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“…However, ADT is not curative in patients with locally advanced or metastatic disease 3, 4, 5, 6, 7. Despite the initial response to ADT, most patients will experience disease progression and the development of castration-resistant PC (CRPC) 8, 9. The majority of previous studies reported that a longer time to the prostate-specific antigen (PSA) nadir was associated with better survival 10, 11, 12.…”

Section: Introductionmentioning

confidence: 99%

Predictive factor of androgen deprivation therapy for patients with advanced stage prostate cancer

Kongseang

Attawettayanon

Kanchanawanichkul

et al. 2017

Prostate International

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BackgroundThe purpose of this study was to identify the predictive factors for the efficacy of androgen deprivation therapy (ADT) in men with hormone-sensitive prostate cancer (PC) with or without distant metastasis.MethodsA retrospective review of PC patients was conducted of the medical records. We enrolled 246 patients who received primary ADT. PC patients treated with ADT for presumed nonlocalized PC were evaluated on the efficacy of ADT using prostate-specific antigen (PSA) time to progression (TTP) and compared factors associated with TTP in patients with distant metastasis and patients without distant metastasis.ResultsA total of 246 patients were treated primarily with ADT. The median follow-up period was 20.2 months. One hundred and ninety-one patients had metastatic disease. The median TTP on ADT for the distant metastasis group was 14.8 months versus 60.1 months in the without distant metastasis group (P < 0.0001). In the univariate analysis only, PSA nadir after ADT was associated with longer TTP (hazard ratio, 10.69; 95% confidence interval, 5.56–20.57). In the multivariate analysis, high grade tumor and PSA nadir were independent factors associated with a shorter TTP.ConclusionIn this study of hormone-sensitive PC patients treated with ADT for nonlocalized PC, high grade tumor and PSA nadir were predicting factors of this treatment.

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The slope associated with nadir prostate‐specific antigen is prognostically significant in men with hormone‐sensitive prostate cancer after primary androgen deprivation therapy

et al. 2022

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Background Prognostic indicators based on the initial prostate‐specific antigen (PSA) levels, nadir PSA, and time to PSA nadir were calculated to evaluate prognosis after primary androgen deprivation therapy (PADT), as these have been reported in very few studies. We attempted to evaluate the prognostic role of the slope associated with nadir PSA in patients treated with PADT. Methods A total of 107 patients who were treated with PADT from 2015 to 2019 were reviewed. The Kaplan–Meier method and Cox regression model were used to analyze the prognostic significance of the slope associated with nadir PSA in predicting progression‐free survival (PFS) and overall survival (OS). Results After PADT, the median follow‐up duration was 40.1 months; 66 patients (61.7%) had disease progression, and 33 patients (30.8%) died. In the univariate analysis, T stage, N stage, nadir PSA, time to PSA nadir, nadir PSA declining slope (nPSA‐DS), nadir PSA percentage declining slope (nPSA‐PDS), and nadir PSA line slope (nPSA‐LS) were significant predictors for PFS and OS. The multivariate analysis showed that a higher nPSA‐DS (> − 0.74) and lower PSA nadir (≤0.16 ng/ml) were independent predictors for prolonged survival. The significance of nPSA‐DS and nPSA was supported by the analysis of nPSA‐DS and nPSA as time‐dependent covariates. The combined analyses demonstrated that patients with a higher nPSA‐DS and lower PSA nadir had the best PFS and OS. Conclusions The slope associated with the nadir PSA of nPSA‐DS was a significant independent predictor for patients treated with PADT. Nadir PSA and nPSA‐DS have a synergistic effect on prognosis.

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Prognostic Significance of Time to Prostate-Specific Antigen (PSA) Nadir and Its Relationship to Survival Beyond Time to PSA Nadir for Prostate Cancer Patients With Bone Metastases After Primary Androgen Deprivation Therapy

Abstract: In this study, TTPN was a good prognostic indicator for PFS beyond TTPN and OS beyond TTPN in metastatic prostate cancer cases after primary ADT. Different TTPNs had different implications for predicting survival beyond TTPN.

Cited by 31 publications

References 14 publications

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

Predictive factor of androgen deprivation therapy for patients with advanced stage prostate cancer

The slope associated with nadir prostate‐specific antigen is prognostically significant in men with hormone‐sensitive prostate cancer after primary androgen deprivation therapy

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