Prostatic Specific Antigen and the Prediction of Prognosis in Metastatic Prostatic Cancer

Cooper, Edward H.; Armitage, T. G.; Robinson, M. R. G.; Newling, D. W. W.; Richards, B.; Smith, Philip H.; Denis, L.; Sylvester, Richard

doi:10.1002/cncr.1990.66.s5.1025

Cited by 78 publications

(34 citation statements)

References 8 publications

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“…The favorable outcome observed in patients with a signifi cant and prompt PSA decrease in the current study has already been pointed out by several authors [6,7,9,10], indicating the relationship between PSA changes and sur vival in metastatic prostate cancer receiving hormonal manipulation. How to express the degree of PSA decrease, however, still remained debatable.…”

Section: Discussionsupporting

confidence: 50%

Prognostic Significance of Prostate-Specific Antigen Levels Two Months after Hormonal Manipulation of Metastatic Prostate Cancer

Kawakami

K²,

Yonese³

et al. 1997

Eur Urol

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Section: Discussionsupporting

confidence: 50%

Prognostic Significance of Prostate-Specific Antigen Levels Two Months after Hormonal Manipulation of Metastatic Prostate Cancer

Kawakami

K²,

Yonese³

et al. 1997

Eur Urol

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“…An increase in PSA levels seems to precede a clinical relapse by months [18], and it has therefore also been used as a surrogate end-point in clinical trials. In this study, we assessed the prognostic value of PSA response in hormonally treated prostate cancer.…”

Section: Discussionmentioning

confidence: 99%

PSA Decline Is an Independent Prognostic Marker in Hormonally Treated Prostate Cancer

et al. 1999

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“…We also demonstrated that well-known pretreatment factors, including PSA levels, ALP, EOD score and biopsy GS, [15][16][17] as well as newly developed pathological factors, including G5 volume index, primary G5 volume index and GS9-10 volume index, and post-treatment PSA status, including PSA nadir at any stage of hormonal therapy, could predict overall survival in patients with distant and nonregional lymph node metastases, by univariate analyses.…”

Section: Discussionmentioning

confidence: 65%

Impact of pretreatment factors, biopsy Gleason grade volume indices and post-treatment nadir PSA on overall survival in patients with metastatic prostate cancer treated with step-up hormonal therapy

Miyamoto

Ito

Miyakubo

et al. 2011

Prostate Cancer Prostatic Dis

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BACKGROUND:In the era when various treatment agents for advanced-stage prostate cancer are available, it is important to investigate overall survival for metastatic prostate cancer treated with step-up hormonal treatment as a reference against new treatment regimens, including antitumor agents and/or new hormonal derivatives, and it is desirable to explore pretreatment, biopsy-related and post-treatment prognostic factors to establish tailor-made treatment strategies. METHODS:Between 1992 and 2002, 94 patients were diagnosed with prostate cancer with distant metastases in our facility. Various pretreatment clinical findings including serum PSA, testosterone, alkaline phosphatase (ALP), digital rectal examination (DRE) and extension of disease score were investigated for predicting outcomes in step-up hormonal treatment. We also investigated the impact of pathological findings including Gleason grading, tumor volume indices, various Gleason grade 5 volume indices in biopsy specimens, and post-treatment PSA nadir following step-up hormonal treatment on overall survival. RESULTS:The 3-and 5-year overall survival was 72.4% and 62.5%, respectively. According to univariate analyses, patients with PSA p100 ng ml -1 , ALP o440 IU l -1 , T1c to T3 on DRE, extension of disease (EOD) score 0-3, no Gleason grade 5 cancer in biopsy specimens or less such cancer and good response at any stage of hormonal therapy had significantly better overall survival than did patients with alternative status. A multivariate Cox proportional hazard model revealed that PSA nadir after first-line hormonal treatment, PSA nadir after second-line treatment and Gleason grade 5 volume index were independent prognostic factors.CONCLUSIONS: Even in very advanced prostate cancer, local pathological indices, a Gleason grade 5 volume index in particular, could differentiate patients with better prognosis from worse prognosis.Step-up hormonal therapy including luteinizing hormone-releasing hormone agonist, estrogen derivatives and steroid hormones may be valuable in patients with metastatic prostate cancer, especially in good responders at any stage of hormonal therapy.

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Prostatic Specific Antigen and the Prediction of Prognosis in Metastatic Prostatic Cancer

Cited by 78 publications

References 8 publications

Prognostic Significance of Prostate-Specific Antigen Levels Two Months after Hormonal Manipulation of Metastatic Prostate Cancer

Prognostic Significance of Prostate-Specific Antigen Levels Two Months after Hormonal Manipulation of Metastatic Prostate Cancer

PSA Decline Is an Independent Prognostic Marker in Hormonally Treated Prostate Cancer

Impact of pretreatment factors, biopsy Gleason grade volume indices and post-treatment nadir PSA on overall survival in patients with metastatic prostate cancer treated with step-up hormonal therapy

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