The Change of Serum Prostate Specific Antigen after Hormonal Therapy of Metastatic Prostatic Cancer

Na, Kyoung Il; Yoon, Duck Ki; Cho, Jae Heung

Abstract

The prostate specific antigen (PSA) is most valuable in monitoring the disease status and treatment response, especially in patients with advanced metastatic adenocarcinoma of the prostate. Between January 1992 and August 1995, we longitudinally followed PSA levels in 29 patients with newly diagnosed metastatic prostate cancer who were treated with orchiectomy, orchiectomy plus antiandrogen daily, or gonadotropin-releasing hormone analogue monthly plus antiandrogen daily The mean length of follow up and the mean age for the 19 patients who survived were 22 months and 70 years, for the 10 patients who expired were 23.8 months and 65 years. The mean value (+/-SD) of pre-treatment PSA level and post-treatment PSA level at 1 month were 213.5+/-395.1 ng/ml, 21.1+/-31.9 ng/ml in survival group and 128.9+/-112.3 ng/ml, 55.6+/-62.3 ng/ml in expired group. respectively The mean value (+/-SD) of nadir PSA level was 11.3+/-26.2 ng/ml in survival group and 18.4+/-2l.2 ng/ml in expired group. The mean value (+/-SD) of time to nadir PSA and time to PSA elevation were 166.2+/-156.0 days, 206+/-115 days in survival group and 278+/-180 days, 155+/-91 days in expired group, respectively. In this study, the mean value (+/-SD) of post-treatment PSA level at 1 month was higher and the mean value (+/-SD) of time to nadir PSA was longer in expired group than survival group (p<0.05). Even though statistically significant differences were not noticed, there was a tendency to be higher nadir PSA level, shorter time to PSA elevation in expired group. Pre-treatment PSA level may not significantly influence survival. Further large-scaled prospective studies are needed to determine the significant role of the changes of PSA after androgen blocking in patients with metastatic prostate cancer.