Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Urology
Published in: BMC Urology 1/2014

Open Access 01-12-2014 | Research article

Nadir PSA level and time to nadir PSA are prognostic factors in patients with metastatic prostate cancer

Authors: Atsushi Tomioka, Nobumichi Tanaka, Motokiyo Yoshikawa, Makito Miyake, Satoshi Anai, Yoshitomo Chihara, Eijiro Okajima, Akihide Hirayama, Yoshihiko Hirao, Kiyohide Fujimoto

Published in: BMC Urology | Issue 1/2014

Login to get access

Abstract

Background

Primary androgen deprivation therapy (PADT) is the most effective systemic therapy for patients with metastatic prostate cancer. Nevertheless, once PSA progression develops, the prognosis is serious and mortal. We sought to identify factors that predicted the prognosis in a series of patients with metastatic prostate cancer.

Methods

Two-hundred eighty-six metastatic prostate cancer patients who received PADT from 1998 to 2005 in Nara Uro-Oncology Research Group were enrolled. The log-rank test and Cox’s proportional hazards model were used to determine the predictive factors for prognosis; rate of castration-resistant prostate cancer (CRPC) and overall survival.

Results

The median age, follow-up period and PSA level at diagnosis were 73 years, 47 months and 174 ng/mL, respectively. The 5-year overall survival rate was 63.0%. The multivariable analysis showed that Gleason score (Hazard ratio [HR]:1.362; 95% confidence interval [C.I.], 1.023-1.813), nadir PSA (HR:6.332; 95% C.I., 4.006-9.861) and time from PADT to nadir (HR:4.408; 95% C.I., 3.099-6.271) were independent prognostic factors of the incidence of CRPC. The independent parameters in the multivariate analysis that predicted overall survival were nadir PSA (HR:5.221; 95% C.I., 2.757-9.889) and time from PADT to nadir (HR:4.008; 95% C.I., 2.137-7.517).

Conclusions

Nadir PSA and time from PADT to nadir were factors that affect both CRPC and overall survival in a cohort of patients with metastatic prostate cancer. Lower nadir PSA level and longer time from PADT to nadir were good for survival and progression.
Literature
1.
Matsuda A, Matsuda T, Shibata A, Katanoda K, Sobue T, Nishimoto H: Cancer Incidence and Incidence Rates in Japan in, A Study of 21 Population-based Cancer Registries for the Monitoring of Cancer Incidence in Japan (MCIJ) Project. Jpn J Clin Oncol. 2007, 2013 (43): 328-336.
2.
Tanaka N, Fujimoto K, Hirayama A, Yoneda T, Yoshida K, Hirao Y: Trends of the primary therapy for patients with prostate cancer in Nara uro-oncological research group (NUORG): a comparison between the CaPSURE data and the NUORG data. Jpn J Clin Oncol. 2010, 40: 588-592. 10.1093/jjco/hyq008.CrossRefPubMed
3.
Tanaka N, Hirayama A, Yoneda T, Yoshida K, Shimada K, Konishi N, Fujimoto K: Trends of risk classification and primary therapy for Japanese patients with prostate cancer in Nara Uro-Oncological Research Group (NUORG)-a comparison between 2004–2006 and 2007–2009. BMC Cancer. 2013, 10: 588-CrossRef
4.
D'Amico AV, Chen MH, Roehl KA, Catalona WJ: Preoperative PSA velocity and the risk of death from prostate cancer after radical prostatectomy. N Engl J Med. 2004, 351: 125-135. 10.1056/NEJMoa032975.CrossRefPubMed
5.
Miller JI, Ahmann FR, Drach GW, Emerson SS, Bottaccini MR: The clinical usefulness of serum prostate specific antigen after hormonal therapy of metastatic prostate cancer. J Urol. 1992, 147: 956-961.PubMed
6.
Scher HI, Halabi S, Tannock I, Morris M, Stemberg CN, Carducci MA, Eisenberger MA, Higano C, Bubley GJ, Dreicer R, Petrylak D, Kantoff P, Basch E, Kelly WK, Figg WD, Small EJ, Beer TM, Wilding G, Martin A, Hussain M: Prostate Cancer Clinical Trials Working Group: Design and end points of clinical trials for patients with progressive prostate cancer and castrate levels of testosterone: recommendations of the Prostate Cancer Clinical Trials Working Group. J Clin Oncol. 2008, 26: 1148-1159. 10.1200/JCO.2007.12.4487.CrossRefPubMedPubMedCentral
7.
Bubley GJ, Carducci M, Dahut W, Dawson N, Daliani D, Eisenberger M, Figg WD, Freidlin B, Halabi S, Hudes G, Hussain M, Kaplan R, Myers C, Oh W, Petrylak DP, Reed E, Roth B, Sartor O, Scher H, Simons J, Sinibaldi V, Small EJ, Smith MR, Trump DL, Wilding G: Eligibility and response guidelines for phase II clinical trials in androgen-independent prostate cancer: recommendations from the Prostate-Specific Antigen Working Group. J Clin Oncol. 1999, 17: 3461-3467.PubMed
8.
Hussain M, Goldman B, Tangen C, Higano CS, Petrylak DP, Wilding G, Akdas AM, Small EJ, Donnelly BJ, Sundram SK, Burch PA, Dipaola RS, Crawford ED: Prostate-specific antigen progression predicts overall survival in patients with metastatic prostate cancer: data from Southwest Oncology Group Trials 9346 (Intergroup Study 0162) and 9916. J Clin Oncol. 2009, 27: 2450-2456. 10.1200/JCO.2008.19.9810.CrossRefPubMedPubMedCentral
9.
Sobin LH, Wittekind CH: TNM Classification of Malignant Tumors. 2002, New York: Wiley-Liss Inc., 184-187. 6
10.
Arai Y, Yoshiki T, Yoshida O: Prognostic significance of prostate specific antigen in endocrine treatment for prostatic cancer. J Urol. 1990, 144: 1415-1419.PubMed
11.
Matzkin H, Eber P, Todd B, van der Zwaag R, Soloway MS: Prognostic significance of changes in prostate-specific markers after endocrine treatment of stage D2 prostatic cancer. Cancer. 1992, 70: 2302-2309. 10.1002/1097-0142(19921101)70:9<2302::AID-CNCR2820700915>3.0.CO;2-2.CrossRefPubMed
12.
Newling DW, Denis L, Vermeylen K: Orchiectomy versus goserelin and flutamide in the treatment of newly diagnosed metastatic prostate cancer. Analysis of the criteria of evaluation used in the European Organization for Research and Treatment of Cancer–Genitourinary Group Study 30853. Cancer. 1993, 72: 3793-3798. 10.1002/1097-0142(19931215)72:12+<3793::AID-CNCR2820721706>3.0.CO;2-U.CrossRefPubMed
13.
Benaim EA, Pace CM, Lam PM, Roehrborn CG: Nadir prostate-specific antigen as a predictor of progression to androgen-independent prostate cancer. Urology. 2002, 59: 73-78. 10.1016/S0090-4295(01)01440-6.CrossRefPubMed
14.
Cooper EH: Prostate specific antigen in diagnosis, staging, and follow-up of prostate cancer. Prostate Suppl. 1992, 4: 125-128.CrossRefPubMed
15.
Dijkman GA, Janknegt RA, De Reijke TM, Debruyne FM: Long-term efficacy and safety of nilutamide plus castration in advanced prostate cancer, and the significance of early prostate specific antigen normalization. International Anandron Study Group. J Urol. 1997, 158: 160-163. 10.1097/00005392-199707000-00051.CrossRefPubMed
16.
Morote J, Trilla E, Esquena S, Abascal JM, Reventos J: Nadir prostate-specific antigen best predicts the progression to androgen-independent prostate cancer. Int J Cancer. 2004, 108: 877-881. 10.1002/ijc.11639.CrossRefPubMed
17.
Kiper A, Yigitbasi O, Imamoglu A, Tuygun C, Turan C: The prognostic importance of prostate specific antigen in the monitorisation of patients undergoing maximum androgen blockade for metastatic prostate cancer. Int Urol Nephrol. 2006, 38: 571-576.CrossRefPubMed
18.
Choueiri TK, Xie W, D’Amico AV, Ross EW, Hu JC, Pomerantz M, Regan MM, Taplin ME, Kantoff PW, Sartor O, Oh WK: Time to prostate-specific antigen nadir independently predicts overall survival in patients who have metastatic hormone-sensitive prostate cancer treated with androgen-deprivation therapy. Cancer. 2009, 115: 981-987. 10.1002/cncr.24064.CrossRefPubMedPubMedCentral
19.
Kwak C, Jeong SJ, Park MS, Lee E, Lee SE: Prognostic significance of the nadir prostate specific antigen level after hormone therapy for prostate cancer. J Urol. 2002, 168: 995-1000. 10.1016/S0022-5347(05)64559-4.CrossRefPubMed
20.
Park SC, Rim JS, Choi HY, Kim CS, Hong SJ, Kim WJ, Lee SE, Song JM, Yoon JH: Failing to achieve a nadir prostate-specific antigen after combined androgen blockade: predictive factors. Int J Urol. 2009, 16: 670-675. 10.1111/j.1442-2042.2009.02329.x.CrossRefPubMed
21.
Sim HG, Lau WK, Cheng CW: Predictors of androgen independence in metastatic prostate cancer. BJU Int. 2004, 93: 1221-1224. 10.1111/j.1464-410X.2004.04863.x.CrossRefPubMed
22.
Hussain M, Tangen CM, Higano C, Schelhammer PF, Faulkner J, Crawford ED, Wilding G, Akdas A, Small EJ, Donnelly B, MacVicar G, Raghavan D: Southwest Oncology Group Trial 9346 (INT-0162): Absolute prostate-specific antigen value after androgen deprivation is a strong independent predictor of survival in new metastatic prostate cancer: data from Southwest Oncology Group Trial 9346 (INT-0162). J Clin Oncol. 2006, 24: 3984-3989. 10.1200/JCO.2006.06.4246.CrossRefPubMed
23.
Sasaki T, Ohnishi T, Hoshina A: Nadir PSA level and time to PSA nadir following primary androgen deprivation therapy are the early survival predictors for prostate cancer patients with bone metastasis. Prostate Cancer Prostatic dis. 2011, 14: 248-252. 10.1038/pcan.2011.14.CrossRefPubMed
24.
Huang SP, Bao BY, Wu MT, Choueiri TK, Goggins WB, Huang CY, Pu YS, Yu CC, Huang CH: Impact of prostate-specific antigen (PSA) nadir and time to PSA nadir on disease progression in prostate cancer treated with androgen-deprivation therapy. Prostate. 2011, 71: 1189-1197. 10.1002/pros.21334.CrossRefPubMed
Metadata
Title
Nadir PSA level and time to nadir PSA are prognostic factors in patients with metastatic prostate cancer
Authors
Atsushi Tomioka
Nobumichi Tanaka
Motokiyo Yoshikawa
Makito Miyake
Satoshi Anai
Yoshitomo Chihara
Eijiro Okajima
Akihide Hirayama
Yoshihiko Hirao
Kiyohide Fujimoto
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2014
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/1471-2490-14-33

Other articles of this Issue 1/2014

BMC Urology 1/2014 Go to the issue

Research article

Determinants and effects of positive surgical margins after prostatectomy on prostate cancer mortality: a population-based study

Review

Changing paradigms in management of metastatic Castration Resistant Prostate Cancer (mCRPC)

Research article

Early results of a novel technique for anterior vaginal wall prolapse repair: anterior vaginal wall darn

Research article

Evaluation of national trends in the utilization of partial nephrectomy in relation to the publication of the American Urologic Association guidelines for the management of clinical T1 renal masses

Research article

Functional aspects of silent ureteral stones investigated with MAG-3 renal scintigraphy

Research article

One-stage dorsal inlay oral mucosa graft urethroplasty for anterior urethral stricture