887 PROGNOSTIC PREDICTORS FOR TIME TO CLINICAL PROGRESSION AND CASTRATION RESISTANCE IN

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced1 Apr 2011887 PROGNOSTIC PREDICTORS FOR TIME TO CLINICAL PROGRESSION AND CASTRATION RESISTANCE IN Alessandro Sciarra, Stefano Salciccia, Andrea Alfarone, Susanna Cattarino, Alessandro Gentilucci, Ulderico Parente, and Vincenzo Gentile Alessandro SciarraAlessandro Sciarra Rome, Italy More articles by this author , Stefano SalcicciaStefano Salciccia Rome, Italy More articles by this author , Andrea AlfaroneAndrea Alfarone Rome, Italy More articles by this author , Susanna CattarinoSusanna Cattarino Rome, Italy More articles by this author , Alessandro GentilucciAlessandro Gentilucci Rome, Italy More articles by this author , Ulderico ParenteUlderico Parente Rome, Italy More articles by this author , and Vincenzo GentileVincenzo Gentile Rome, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.753AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The purpose of this analysis was to define characteristics of the first cycle of intermittent androgen deprivation (IAD) that would predict for outcomes in a long term follow-up. METHODS In 1996 we started a prospective study of IAD for the treatment of biochemical progression (BP) (PSA increase > 0.2 ng/ml) after radical prostatectomy (RP) for prostate adenocarcinoma (PC). The primary end-point of the trial was time to clinical progression (CP) but also time to castration resistance PC (CRPC). Eighty-four cases fulfilled the inclusion criteria and were included in the study. In all cases, after an initial induction period, an acceptable nadir to switch from on-to-off-phase of IAD was considered to be a serum PSA of less than 1.0 ng/ml. As possible predictors for time to CP and CRPC we analyzed pretreatment parameters such as age, Gleason Score, serum PSA, testosterone and Chromogranina A (CgA) levels and also characteristics from the first cycle of IAD. RESULTS Mean follow-up during IAD was 88.69 À 16.74 months; 29.77% of patients developed CRPC and 14.28% of cases showed a CP with a mean time of 88.40 À 14.34 months and 106.50 À 20.65 months respectively. At the univariate and multivariate analysis the PSA nadir during the first on-phase period and the first off-phase interval resulted significant and independent predictors (p<0.001) of the time to CRPC and CP. In particular for cases with a PSA nadir > 0.4 ng/ml and for those with an off-phase interval Ù 24 weeks, the risk of CRPC and CP during IAD was 2.7–2.5 and 3.0–3.1 times that for patients with a PSA nadir Ù 0.1 ng/ml and with an off-phase interval > 48 weeks respectively. The predictive value of these two parameters resulted significant also after adjusting for age, stage, Gleason score and PSA at diagnosis or at BP. CONCLUSIONS Cases with BP after RP selected to IAD that show at the first cycle a PSA nadir Ù 0.1 ng/ml and a off-phase interval ¡Ý 48 weeks, are the best candidate for long IAD treatments without the development of CRPC or CP. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e355 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alessandro Sciarra Rome, Italy More articles by this author Stefano Salciccia Rome, Italy More articles by this author Andrea Alfarone Rome, Italy More articles by this author Susanna Cattarino Rome, Italy More articles by this author Alessandro Gentilucci Rome, Italy More articles by this author Ulderico Parente Rome, Italy More articles by this author Vincenzo Gentile Rome, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...