The Prognostic Importance of Prostate-Specific Antigen in Monitoring Patients Undergoing Maximum Androgen Blockade for Metastatic Prostate Cancer

Abstract

The changes in serum prostate-specific antigen (PSA) concentrations can be used as a prognostic factor in patients undergoing maximum androgen blockade for metastatic prostate cancer. Materials and methods One hundred and forty-nine patients followed-up in our department were classified into four groups based on PSA changes. Group 1, those with a normalization of PSA levels within the 1st 3 months; group 2, those with a normalization of PSA levels between months 3 and 6; group 3, those with a reduction in PSA levels, but not reaching the normal range; group 4, those with no reduction in PSA levels. The gleason scores and the number of bone metastases were also compared between the groups. Results The time to progression was significantly delayed in group 1 (mean: 23.3 months) compared to that of group 2 (mean: 16.9 months) (p<0.02). The time to progression in group 3 (mean: 8.45 months) was significantly shorter compared to groups 1 and 2 (p<0.001). In addition, in patients with gleason scores 5–7 (grade 2) and gleason scores >7 (grade 3) and in group 1, the time to progression (mean: 21.2 months) was significantly delayed compared to those with the same gleason scores but in group 2 (mean: 13.4 months) (p<0.001). Conclusion The reduction in PSA levels is more important than gleason scores in determining the time to progression. Early normalization of PSA levels delays the time to progression, and when combined with gleason scores, PSA is an important prognostic factor in predicting the success of the therapy.