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Published in: Annals of Surgical Oncology 4/2015

01-04-2015 | Urologic Oncology

Prognostic Significance of Time to Prostate-Specific Antigen (PSA) Nadir and Its Relationship to Survival Beyond Time to PSA Nadir for Prostate Cancer Patients With Bone Metastases After Primary Androgen Deprivation Therapy

Authors: Jeremy Yuen Chun Teoh, MRCSEd, James Hok Leung Tsu, FRCSEd, FHKAM, Steffi Kar Kei Yuen, MRCSEd, Samson Yun Sang Chan, MRCSEd, Peter Ka Fung Chiu, FRCSEd, FHKAM, Wai-Man Lee, MSc, Ka-Wing Wong, MRCSEd, Kwan-Lun Ho, FRCSEd, FHKAM, Simon See Ming Hou, FHKAM, Chi-Fai Ng, FRCSEd, FHKAM, Ming-Kwong Yiu, FRCSEd, FHKAM

Published in: Annals of Surgical Oncology | Issue 4/2015

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Abstract

Background

This study investigated the prognostic significance of time to the prostate-specific antigen nadir (TTPN) and its relationship to survival beyond TTPN in metastatic prostate cancer after primary androgen-deprivation therapy (ADT).

Methods

All metastatic prostate cancer patients treated with primary ADT from 2000 to 2009 were reviewed. The prognostic significance of TTPN in predicting progression-free survival (PFS) beyond TTPN and overall survival (OS) beyond TTPN was analyzed using the Cox regression model. The median PFS and OS were plotted against TTPN on a monthly interval. The PFS beyond TTPN and the OS beyond TTPN with reference to TTPN were calculated and presented.

Results

The study enrolled 419 patients with a median follow-up period of 38 months. The findings showed that TTPN was a significant prognostic indicator for both PFS beyond TTPN (hazard ratio [HR] 0.72, 95 % confidence interval [CI] 0.52–0.99, p = 0.04) and OS beyond TTPN (HR 0.65, 95 % CI 0.47–0.90, p = 0.01) according to Cox regression analyses. The relationship between TTPN and survival beyond TTPN consisted of three phases. In the first phase (<3 months for PFS and <6 months for OS), the survival beyond TTPN increased with TTPN. In the second phase (3–17 months for PFS and 6–20 months for OS), the survival beyond TTPN remained relatively static. In the third phase (>17 months for PFS and >20 months for OS), the survival beyond TTPN increased exponentially with TTPN.

Conclusions

In this study, TTPN was a good prognostic indicator for PFS beyond TTPN and OS beyond TTPN in metastatic prostate cancer cases after primary ADT. Different TTPNs had different implications for predicting survival beyond TTPN.
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Metadata
Title
Prognostic Significance of Time to Prostate-Specific Antigen (PSA) Nadir and Its Relationship to Survival Beyond Time to PSA Nadir for Prostate Cancer Patients With Bone Metastases After Primary Androgen Deprivation Therapy
Authors
Jeremy Yuen Chun Teoh, MRCSEd
James Hok Leung Tsu, FRCSEd, FHKAM
Steffi Kar Kei Yuen, MRCSEd
Samson Yun Sang Chan, MRCSEd
Peter Ka Fung Chiu, FRCSEd, FHKAM
Wai-Man Lee, MSc
Ka-Wing Wong, MRCSEd
Kwan-Lun Ho, FRCSEd, FHKAM
Simon See Ming Hou, FHKAM
Chi-Fai Ng, FRCSEd, FHKAM
Ming-Kwong Yiu, FRCSEd, FHKAM
Publication date
01-04-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 4/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4105-8

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