MP87-06 NADIR TESTOSTERONE AFTER LONG-TERM FOLLOW-UP PREDICTS PROGNOSIS OF PROSTATE CANCER PATIENTS TREATED WITH COMBINED ANDROGEN BLOCKADE

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced III1 Apr 2015MP87-06 NADIR TESTOSTERONE AFTER LONG-TERM FOLLOW-UP PREDICTS PROGNOSIS OF PROSTATE CANCER PATIENTS TREATED WITH COMBINED ANDROGEN BLOCKADE Shuhei Kamada, Shinichi Sakamoto, Keisuke Ando, Ayumi Muroi, Miki Fuse, Koji Kawamura, Takashi Imamoto, Hiroyoshi Suzuki, Maki Nagata, Naoki Nihei, Koichiro Akakura, and Tomohiko Ichikawa Shuhei KamadaShuhei Kamada More articles by this author , Shinichi SakamotoShinichi Sakamoto More articles by this author , Keisuke AndoKeisuke Ando More articles by this author , Ayumi MuroiAyumi Muroi More articles by this author , Miki FuseMiki Fuse More articles by this author , Koji KawamuraKoji Kawamura More articles by this author , Takashi ImamotoTakashi Imamoto More articles by this author , Hiroyoshi SuzukiHiroyoshi Suzuki More articles by this author , Maki NagataMaki Nagata More articles by this author , Naoki NiheiNaoki Nihei More articles by this author , Koichiro AkakuraKoichiro Akakura More articles by this author , and Tomohiko IchikawaTomohiko Ichikawa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1951AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The most clinically significant castration level during androgen deprivation therapy (ADT) remains controversial. Moreover, most past studies assessed testosterone (TST) levels at 3 to 6 months, and the effect of long-term ADT on serum TST levels is not known. The present study examined the clinical significance of long-term serum TST monitoring in predicting the prognosis of prostate cancer patients treated with combined androgen blockade (CAB). METHODS A total of 225 patients who underwent CAB as 1st-line therapy for prostate cancer at Chiba University Hospital and its affiliated hospital (1999-2014) were retrospectively analyzed. The prognostic values of the serum TST level and other clinical factors were evaluated in association with PSA progression-free survival (PFS) and overall survival (OS). Univariate and multivariate Cox hazard proportional models and the Kaplan-Meier method were used for statistical analysis. RESULTS The patients' average age was 72.3 years. The median PSA was 42.6 ng/mL. The average follow-up was 32.7 months. No variable associated with TST was predictive of PFS. With regard to OS, on univariate analysis, nadir TSTs of 20, 32 ng/dL, and nadir TST of 20 ng/dL at 6 months were significant prognostic factors together with other clinical factors including PSA. In contrast, nadir TST 8 ng/dL was not significant. Multivariate analysis showed that the most significant prognostic factor was nadir TST of 20 ng/dL (p=0.0004), but nadir TST of 20 ng/dL at 6 months was not significant. Although the lowest nadir TST <8 ng/dL was not a significant prognostic factor for OS, patients who achieved a lower nadir TST survived longer. In addition, time to nadir TST was 16.2 months, then we divided patients into rapid type and slow type, based on time to TST 20 ng/dL before and after 6 months, respectively. No significant difference in OS was observed between two types. The present results indicate that the critical factor for prognosis was not a rapid decrease, but rather the absolute decrease of the TST levels. CONCLUSIONS Nadir TST of 20 ng/dL was the most significant prognostic factor for OS in patients treated with CAB. Interestingly enough, the time needed to reach the nadir TST was over 1 year (16.2 months), suggesting the importance of long-term serum TST testing. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1086 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shuhei Kamada More articles by this author Shinichi Sakamoto More articles by this author Keisuke Ando More articles by this author Ayumi Muroi More articles by this author Miki Fuse More articles by this author Koji Kawamura More articles by this author Takashi Imamoto More articles by this author Hiroyoshi Suzuki More articles by this author Maki Nagata More articles by this author Naoki Nihei More articles by this author Koichiro Akakura More articles by this author Tomohiko Ichikawa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...