Prostate-specific antigen nadir and cancer-specific mortality following hormonal therapy for prostate-specific antigen failure Journal Article


Authors: Stewart, A. J.; Scher, H. I.; Chen, M. H.; McLeod, D. G.; Carroll, P. R.; Moul, J. W.; D'Amico, A. V.
Article Title: Prostate-specific antigen nadir and cancer-specific mortality following hormonal therapy for prostate-specific antigen failure
Abstract: Purpose For men receiving androgen-suppression therapy (AST) for a rising postoperative or postradiation prostate-specific antigen (PSA), we evaluated whether a PSA nadir of more than 0.2 ng/mL was significantly associated with prostate cancer-specific mortality (PCSM). Patients and Methods The study cohort comprised 747 men with rising PSA and negative bone scan after surgery (n = 486) or radiation therapy (n = 261) who were treated with AST. Cox regression was used to evaluate whether a significant association existed between the PSA nadir level after 8 months of AST and the time to PCSM, controlling for treatment and known prognostic factors. Results The post-AST PSA nadir (p(Cox) < .0001), the pre-AST PSA doubling time (DT) (p(Cox) = .002), PSA level (P = .0001), and Gleason eight to 10 cancers (p(Cox) = .01) were significantly associated with time to PCSM. The adjusted hazard ratio for PCSM was 20 (95% Cl, 7 to 61; P-Cox < .0001), for men with a PSA nadir of more than 0.2 ng/mL as compared with all others. A PSA DT of less than 3 months was observed in 30% (224 of 747) of the study cohort. Of the 28 observed prostate cancer deaths, 21 (75%) occurred in men whose PSA nadir was more than 0.2 ng/mL and who had a PSA DT of less than 3 months. Conclusion A PSA nadir of more than 0.2 ng/mL after 8 months of AST given for postoperative or postradiation PSA failure is significantly associated with PCSM and is clinically significant because it accounted for 75% of the cancer deaths observed in this study.
Keywords: prednisone; docetaxel; mitoxantrone; radical prostatectomy; radiation-therapy; natural-history; database
Journal Title: Journal of Clinical Oncology
Volume: 23
Issue: 27
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2005-09-20
Start Page: 6556
End Page: 6560
Language: English
DOI: 10.1200/jco.2005.20.966
ACCESSION: WOS:000232233100018
PROVIDER: wos
PUBMED: 16170163
Notes: --- - Article; Proceedings Paper - 41st Annual Meeting of the American-Society-of-Clinical-Oncology - MAY 13-17, 2005 - Orlando, FL - "Source: Wos"
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  1. Howard Scher
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