The Pattern of Prostate-Specific Antigen Responses Fol lowing Hormonal Therapy in Thai Men with Bone Meta static Prostate Cancer
SUNAI LEEWANSANGTONG, MD*, SUCHAI SOONTRAPA,MD*
Affiliation : * Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Bangkok 10700, Thailand.
Objective : To study the pattern of prostate-specific antigen (PSA) responses and prognostic factors following hormonal therapy in Thai men with bone metastatic prostate cancer.
Materials and Methods : Forty-four patients with bone metastatic prostate cancer treated by bilateral orchiectomy were retrospectively studied for PSA responses during follow-up. The endpoint was time to PSA biochemical failure. PSA pattern and the prognostic factors were evaluated.
Results : PSA levels regressed to PSA nadir level in all patients. Time to 50 per cent PSA regression, time to PSA nadir level and time to biochemical failure were 2.1, 6.7 and 11.2 months, respectively. While biochemical failure was present, all patients were alive and had stable clinical con ditions. Tumor grading was an important prognostic factor while age and pretreatment PSA level were not a significant indicator. Times to biochemical failure in the patients with well, moderate and poor differentiated tumors were 19.3, 10.0 and 9.3 months, respectively.
Conclusion : Following bilateral orchiectomy in Thai men with bone metastatic prostate cancer, PSA level decreased continuously to the PSA nadir level in 6-7 months and stable for a period then it increased, known as biochemical failure. The patients with a well differentiated tumor had a significantly longer time to biochemical failure when compared to the patients with a moderate or poor differentiated tumor.
Keywords : Prostate-Specific Antigen, Prostate, Prostatic Carcinoma
