MP73-15 PROSTATE-SPECIFIC ANTIGEN HALF-LIFE IDENTIFIED AT THE FIRST FOLLOW UP TIME IS AN EARLY PROGNOSTIC FACTOR OF NEWLY DIAGNOSED METASTATIC PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced I1 Apr 2015MP73-15 PROSTATE-SPECIFIC ANTIGEN HALF-LIFE IDENTIFIED AT THE FIRST FOLLOW UP TIME IS AN EARLY PROGNOSTIC FACTOR OF NEWLY DIAGNOSED METASTATIC PROSTATE CANCER Ki Hong Kim, Kyung Seok Han, and Sung Joon Hong Ki Hong KimKi Hong Kim More articles by this author , Kyung Seok HanKyung Seok Han More articles by this author , and Sung Joon HongSung Joon Hong More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2691AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Several prostate-specific antigen (PSA) kinetics parameters such as nadir PSA or time to nadir PSA are used commonly as predictive prognostic factors for metastatic prostate cancer (mPCa) patients who have undergone androgen deprivation therapy (ADT). However, they had the limitation in that they were recorded at the same time as when the PSA declined in response to ADT to its lowest point, which is a time point that cannot be predicted in advance. Therefore, earlier and more clinically available prognostic factors are needed. We examined the PSA half-life (PSAHL) estimated at the first follow-up visit as a prognostic factor of newly diagnosed mPCa. METHODS We performed a retrospective review of 398 newly diagnosed mPCa patients who had undergone ADT. After categorizing the included patients to a long and short PSAHL groups based on a cut-off value identified by Contal and O'Quigely's method, Cox regression analyses were performed to identify independent prognostic factors of newly diagnosed mPCa. The Kaplan-Meier method was used for detecting differences in survival between the two groups. RESULTS Long PSAHL group (HR: 2.383; p<0.001), nadir PSA (HR: 1.004; p<0.001), time to nadir PSA (HR: 0.856; p<0.001), and Gleason score (HR: 2.025; p=0.008) were found to be independent predictors. By the Kaplan-Meier method, the median PCSM-free survival of the short PSAHL group was 73.7 (95% CI, 54.8-92.6) and of the long PSAHL group was 52.5 months (95% CI, 33.4-71.6). This difference between the two groups was found to be statistically significant (p=0.014, log rank test). CONCLUSIONS PSAHL estimated at the first follow-up visit is an independent prognostic factor for newly diagnosed mPCa. If the prospective validation test is performed on a large scale, it may demonstrate that PSAHL is an early surrogate prognostic factor of newly diagnosed mPCa. Table. Predictors of prostate cancer specific mortality (PSAHL as categorical variable) Variable HR 95% CI P Bone pain relative to absence presence 1.468 0.732-2.942 0.279 Gleason score relative to 6-7 8-10 2.025 1.207-3.400 0.008 Clinical T stage relative to <4 ≥4 1.468 0.732-2.942 0.279 Clinical N stage relative to 0 1 1.379 0.954-1.994 0.087 Nadir PSA 1.004 1.002-1.005 <0.001 TTN 0.856 0.823-0.890 <0.001 PSAHL relative to short PSAHL group Long PSAHL group 2.383 2.383 <0.001 ADT, androgen deprivation therapy; IQR, interquartile range; PSA, prostate specific antigen; PS, performance status; TTN, time to nadir PSA; PSAHL, prostate specific antigen half-life © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e935-e936 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ki Hong Kim More articles by this author Kyung Seok Han More articles by this author Sung Joon Hong More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...