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Predictors of survival in prostate cancer patients with bone metastasis and extremely high prostate-specific antigen levels

Authors
 Kyo Chul Koo  ;  Sang Un Park  ;  Ki Hong Kim  ;  Koon Ho Rha  ;  Sung Joon Hong  ;  Seung Choul Yang  ;  Byung Ha Chung 
Citation
 PROSTATE INTERNATIONAL, Vol.3(1) : 10-15, 2015 
Journal Title
PROSTATE INTERNATIONAL
ISSN
 2287-8882 
Issue Date
2015
Keywords
Alkaline phosphatase ; Bone ; Metastasis ; Prostate cancer ; Prostate-specific antigen ; Survival
Abstract
PURPOSE: Prostate-specific antigen (PSA) is a surrogate marker of disease progression; however, its predictive ability in the extreme ranges is unknown. We determined the predictors of survival in patients with bone metastatic prostate cancer (BMPCa) and with extremely high PSA levels.

METHODS: Treatment-naïve patients (n = 248) diagnosed with BMPCa between December 2002 and June 2012 were retrospectively analyzed. Clinicopathological features at diagnosis, namely age, body mass index, serum alkaline phosphatase (ALP) and PSA levels, PSA nadir, time to PSA nadir and its maintenance period, PSA declining velocity, Gleason grade, clinical T stage, pain score, Eastern Cooperative Oncology Group performance score (ECOG PS), and the number of bone metastases were assessed. The patients were stratified according to PSA ranges of <20 ng/mL, 20-100 ng/mL, 100-1000 ng/mL, and 1000-10,000 ng/mL. Study endpoints were castration-resistant PCa (CRPC)-free survival and cancer-specific survival (CSS).

RESULTS: Patients with higher PSA and ALP levels showed more bone lesions (P < 0.001). During the follow-up period (median, 39.9 months; interquartile range, 21.5-65.9 months), there were no differences between the groups in terms of the survival endpoints. High ALP levels, shorter time to PSA nadir, and pain were associated with an increased risk of progression to CRPC, and high ALP levels, ECOG PS ≥ 1, and higher PSA nadir independently predicted CSS.

CONCLUSIONS: PSA response to androgen deprivation therapy and serum ALP are reliable predictors of survival in patients with BMPCa presenting with extremely high PSA levels. These patients should not be deterred from active treatment based on baseline PSA values.
Files in This Item:
T201503654.pdf Download
DOI
10.1016/j.prnil.2015.02.006
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Kim, Ki Hong(김기홍)
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Park, Sang Un(박상언)
Yang, Seung Choul(양승철)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141224
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