[Availability of Local Therapy to Castration-Resistant Prostate Cancer for M0 Patients with Initial Prostate Specific Antigen 100 ng/ml or Higher].

Abstract

Prostate cancer patients with initial PSA 100 ng/ml or greater who received transrectal ultrasoundguided prostate biopsy and were staged as M0 by imaging studies from 2011 to 2014 in seven hospitals, were enrolled in the study. Castration-resistant prostate cancer (CRPC)-free survival was compared between the two treatment groups : androgen deprivation therapy (ADT) alone and ADT plus local therapy. Of 142 prostate cancer patients with initial PSA 100 ng/ml or greater, 49 (34.5%) had no metastases and final analysis was performed on 46 patients. Thirty one M0 patients received ADT alone, and 15 received ADT plus local therapy. During follow-up (median 31 months, range 1-56 months) 13 patients (42%) in the ADT alone group progressed to CRPC. One- and two-year CRPC-free survival rates were 72.5 and 53%, respectively. No patients with ADT plus local therapy developed CRPC, and time to CRPC was prolonged significantly (p=0.002). On multivariate analysis for the group with ADT alone, PSA nadir of more than 0. 2 ng/ml and cN1 were independent predictors for progression to CRPC (p=0.009, 0.031). About one third of prostate cancer patients with initial PSA 100 ng/ml or greater had clinically no metastases. Local therapy to prostate combined with ADT may prolong time to CRPC compared with ADT alone. A subset of men with a PSA nadir of more than 0.2 ng/ml after ADT and cN1 could benefit from local therapy.

• Authors: Akito Kuromoto, Takaki Tanaka, Juntaro Koyama, Takuro Goto, Shingo Kimura, Yuki Katsumata, Shingo Myoen, Michinobu Ozawa, Kento Morozumi, Masahiko Sato, Senji Hoshi, Kenji Numahata, Yoichi Arai
• Journal: Hinyokika kiyo. Acta urologica Japonica (Hinyokika Kiyo) Vol. 63 Issue 12 Pg. 515-520 (Dec 2017) ISSN: 0018-1994 [Print] Japan
• PMID: 29370662 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Prostate-Specific Antigen

Topics

• Aged
• Aged, 80 and over
• Humans
• Male
• Middle Aged
• Prostate-Specific Antigen (blood)
• Prostatic Neoplasms, Castration-Resistant (diagnosis, therapy)
• Retrospective Studies
• Treatment Outcome