The relationship between PSA doubling time and survival in hormone resistant prostate cancer [Hormona dirençli prostat kanserinde PSA'nin İkiye katlanma süresinin hastaliǧa baǧli yaşam süresiyle İlişkisi]

Abstract

Introduction: Surrogate end points are needed in prediction of prognosis in hormone resistant prostate cancer (HRCP). Initial PSA value, Gleason score, extent of metastatic spread and number of metastases have been used for this purpose with limited value. PSA doubling time (DTPSA) has been used in defining the prognosis in prostate cancer and initial results have been hopeful. In this study we analyzed the relationship between DTPSA and patient survival in a cohort of HRPC patients. Materials and Methods: In this retrospective study, 33 patients who were admitted to our department between 1999 and 2004 with the emergence of resistance to hormonal therapy and complete follow-up data were included. The initial PSA value in their first visit, Gleason score, extent of metastatic spread, DTPSA values and survival status were recorded. SPSS 13.0 statistical packet program used for the analysis of the relationship between these variables and survival status. Results: The mean age was 70 (between: 56-92) years. The initial mean PSA value in the first visit was 167.8 (min: 2.5, max: 1399) ng/dl. A total of 27 patients died of their disease and 6 were still alive at the time of data analysis. Subsequent to the emergence of hormone refractory state, mean survival was determined as 20.8 months. Mean survival was 16: months (median: 10.5 months) for those patients with DTPSA value less than 4.7 months and 31.7 (median: 31.4) months in patients with DTPSA value 4.7 months or greater (p=0.01). Mean survival time for the patients who were still alive at the time of analysis was 26 months (median 15.8 months) and it was 18.9 months for the deceased (median 11.6 months). Conclusion: There appears to be a direct relationship between DTPSA and survival in the patients with hormone resistant prostate cancer. For those with DTPSA value greater than 4.7 months, the expected survival was twofold longer. These results indicate DTPSA can be utilized as a prognostic factor in this group of patients.