Abstract
PurposeTo define the efficacy of standard androgen deprivation therapy (ADT) in the treatment of metastatic prostate cancer (PCa).Materials and methodsFifty patients with mean age of 70.48 ± 9.95 years old (range 52–87) who had metastatic PCa and received ADT between 2014 and 2019 were retrospectively evaluated. Median values of pre-therapeutic PSA and Gleason scores were 50 ng/ml (range 8–1201) and 8 (range 6–9), respectively. All patients received luteinizing hormone-releasing hormone (LHRH) analogue and anti-androgen. The patients were evaluated in terms of age, pre-therapeutic PSA serum levels, Gleason scores, presence of metastasis, number and percentage of cores involved, nadir PSA, time to nadir PSA, duration of ADT, and PSA at last follow-up. Multivariate analysis was used to define the factors which have impact on ADT response. The mean follow-up period was 13.87 ± 7.78 months, (range 2–32).ResultsAll patients showed reduction in serum PSA level after initiation of ADT, and the median value of nadir PSA was 1.12 ng/ml (range 0.02–50). The mean value of time to nadir PSA was 3.85 ± 1.57 months (range 2–7). The median value of PSA at last follow-up was 2 ng/ml (range 0.02–50.21). Multi-variant analysis showed that nadir PSA have a significant correlation with pre-therapeutic PSA, PSA at last follow-up, age, and Gleason scores (p < .05).ConclusionStandard ADT is a feasible option in the treatment of metastatic PCa. Gleason scores, age, pre-therapeutic PSA, and PSA at last follow-up have significant impact on outcomes of ADT. Further studies of high number of patients with long-term follow-up including other chemo-hormonal therapy and androgen receptor blockers should be carried out to confirm and improve efficacy of ADT.
Highlights
Prostate cancer (PCa) is one of the most common cancers in male
Standard androgen deprivation therapy (ADT) is a feasible option in the treatment of metastatic PCa
Comparison between patients with Prostate-specific antigens (PSA) less than or more than 1 ng/ml is shown in Table 3, and there were no significant differences between their variables
Summary
Prostate cancer (PCa) is one of the most common cancers in male. rates of detection of PCa vary widely across the world, with Europe and the USA detecting higher frequency than South and East Asia [1]. Yamada et al investigated the establishment of treatment strategy for metastatic PCa in patients with extremely high initial PSA level [9] They found that serum PSA level at diagnosis is considered to be a useful prognostic factor for progression in localized PCa, but in metastatic cancer, it is not of such utility [9]. They concluded that high serum PSA level was associated with favorable response to vintage sequential ADT antiandrogen [9]. We investigated the efficacy of standard ADT in the treatment of primary advanced PCa in patients with high pre-therapeutic serum PSA level
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