BACKGROUND: The prognostic value was determined of prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) measured before and after endocrine treatment in 57 patients with newly diagnosed Stage D2 prostatic cancer. METHODS: Therapy included orchiectomy or administration of luteinizing hormone releasing hormone analogues or an antiandrogen. RESULTS: The absolute pretreatment PSA (elevated in 100% of patients) but not PAP (abnormal in 93%) predicted disease progression (P < 0.0011), i.e., a poor response to therapy. Fifty-three patients responded to androgen deprivation with a decrease in PSA level. This declined to normal at 3 and 6 months in 25% of patients. Forty-nine percent had a greater than 90% decrease in their PSA level. By 1 year, 58% of patients had progressive disease. Both the nadir PSA level and the percent decline from the pretreatment level at 3 and 6 months predicted the progression-free interval (P < 0.001). Patients with a 90% or greater decline in PSA had a prolonged progression-free survival. Serial PAP levels were similarly prognostic. CONCLUSION: It was concluded that PSA was better than PAP in evaluating patients before and after androgen-deprivation therapy. The nadir level of both markers was an important tool to predict progression-free survival in patients with metastatic prostatic cancer.
BACKGROUND: The prognostic value was determined of prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) measured before and after endocrine treatment in 57 patients with newly diagnosed Stage D2 prostatic cancer. METHODS: Therapy included orchiectomy or administration of luteinizing hormone releasing hormone analogues or an antiandrogen. RESULTS: The absolute pretreatment PSA (elevated in 100% of patients) but not PAP (abnormal in 93%) predicted disease progression (P < 0.0011), i.e., a poor response to therapy. Fifty-three patients responded to androgen deprivation with a decrease in PSA level. This declined to normal at 3 and 6 months in 25% of patients. Forty-nine percent had a greater than 90% decrease in their PSA level. By 1 year, 58% of patients had progressive disease. Both the nadirPSA level and the percent decline from the pretreatment level at 3 and 6 months predicted the progression-free interval (P < 0.001). Patients with a 90% or greater decline in PSA had a prolonged progression-free survival. Serial PAP levels were similarly prognostic. CONCLUSION: It was concluded that PSA was better than PAP in evaluating patients before and after androgen-deprivation therapy. The nadir level of both markers was an important tool to predict progression-free survival in patients with metastatic prostatic cancer.
Authors: Ahmet Kiper; Orhan Yiğitbasi; Abdurrahim Imamoglu; Can Tuygun; Celaleddin Turan Journal: Int Urol Nephrol Date: 2006-12-13 Impact factor: 2.370
Authors: William D Figg; Michael E Franks; David Venzon; Paul Duray; Michael C Cox; W Marston Linehan; W Van Bingham; James A Eastham; Eddie Reed; Oliver Sartor Journal: World J Urol Date: 2004-12-08 Impact factor: 4.226
Authors: Marek Cmero; Natalie J Kurganovs; Ryan Stuchbery; Patrick McCoy; Corrina Grima; Anne Ngyuen; Ken Chow; Stefano Mangiola; Geoff Macintyre; Nicholas Howard; Michael Kerger; Philip Dundee; Paul Ruljancich; David Clarke; Jeremy Grummet; Justin S Peters; Anthony J Costello; Sam Norden; Andrew Ryan; Phillip Parente; Christopher M Hovens; Niall M Corcoran Journal: JCO Precis Oncol Date: 2021-06-22