Chromogranin A and biochemical progression-free survival in prostate adenocarcinomas submitted to radical prostatectomy

Abstract

The primary aim of the present study was to determine the prognostic role of elevated levels of chromogranin A (CgA) in terms of biochemical prostate-specific antigen (PSA) progression after radical prostatectomy (RRP) for prostate adenocarcinoma. Two hundred and sixty-four consecutive men with non-metastatic prostate adenocarcinoma submitted to RRP represented our population. In all cases, a blood sample for the determination of serum total PSA and CgA levels was obtained (RIA). Two different upper reference values for serum CgA levels were used: > 60 and > 90 ng/ml. The main end point of this study was biochemical (PSA) progression-free survival. In our population, 35.0% (91/264 cases) of cases presented a serum CgA level > 60 ng/ml and only 6.4% (17/264) presented CgA > 90 ng/ml. After RRP, during a mean follow-up of 64.59 +/- 26.34 months (median 60 months; range 12-120 months), 59 patients (22.3%) showed a biochemical (PSA) progression. Using 60 ng/ml as upper reference value for CgA, 10.4 and 45.0% of cases showed PSA progression after RRP in the group with preoperative CgA levels < or = 60 and > 60 ng/ml respectively. The proportion of PSA progression-free survival was significantly lower in cases with preoperative CgA > 60 ng/ml than in cases with CgA < or = 60 ng/ml (P < 0.0001). In addition, at the multivariate analysis, preoperative serum CgA levels were confirmed as an independent prognostic factor for PSA progression after RRP. In non-metastatic prostate carcinomas, we described a significant prognostic role of CgA in terms of biochemical progression-free survival.