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Prostate Specific Antigen-Related Variables Help Predict Prognosis In Relapsed Prostate Cancer

The shorter the time to the first relapse of prostate cancer and to doubling of prostate specific antigen (PSA) at relapse, the poorer the prognosis, say researchers.

In a study by S. Nakata and colleagues from the department of urology, Ashikaga Red Cross Hospital, Japan, 74 patients who had been treated for prostate cancer but subsequently relapsed were investigated. All had been treated with endocrine therapy, and all of their PSA values had declined to 10 ng/ml or lower during treatment.

In patients with more advanced prostate cancer, defined as clinical stage D, pre-treatment PSA was significantly higher than those with less advanced disease (stage B or C, p<0.01). Patients with more advanced cancer also had a shorter time period from the start of treatment to relapse (p<0.05). The time it took for PSA to double was also shorter for the advanced group (p<0.01).

With respect to response to therapy after the first relapse, both partial and complete response rates were higher among patients with stage B and C cancer, compared with those with stage D cancer. The prognosis was also significantly poorer among patients who relapsed within ten months of the start of the initial treatment and among patients whose time to doubling of PSA at relapse was less than two months.

According to the authors, time to first relapse and doubling time of PSA at relapse were both useful PSA-related predictors of prognosis among patients with relapsed prostate cancer. This information could be useful for determining further therapeutic strategies and helping patients make future plans.
Nippon Hinyokika Gakkai Zasshi 2002 Sep;93(6):686-93. "PSA-related parameters in prostate cancer relapsed after endocrine therapy"

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