Cargando…

Optimal PSA Threshold for Androgen-Deprivation Therapy in Patients with Prostate Cancer following Radical Prostatectomy and Adjuvant Radiation Therapy

PURPOSE: The benefits of early administration of androgen-deprivation therapy (ADT) in patients with prostate-specific antigen (PSA)-only recurrent prostate cancer (PCa) following radical prostatectomy (RP) are controversial. We investigated the impact of early versus delayed ADT on survival outcome...

Descripción completa

Detalles Bibliográficos
Autores principales: Ahn, Hyun Kyu, Lee, Kwang Suk, Kim, Daeho, Rha, Koon Ho, Hong, Sung Joon, Chung, Byung Ha, Koo, Kyo Chul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Yonsei University College of Medicine 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7393290/
https://www.ncbi.nlm.nih.gov/pubmed/32734728
http://dx.doi.org/10.3349/ymj.2020.61.8.652
_version_ 1783565013473034240
author Ahn, Hyun Kyu
Lee, Kwang Suk
Kim, Daeho
Rha, Koon Ho
Hong, Sung Joon
Chung, Byung Ha
Koo, Kyo Chul
author_facet Ahn, Hyun Kyu
Lee, Kwang Suk
Kim, Daeho
Rha, Koon Ho
Hong, Sung Joon
Chung, Byung Ha
Koo, Kyo Chul
author_sort Ahn, Hyun Kyu
collection PubMed
description PURPOSE: The benefits of early administration of androgen-deprivation therapy (ADT) in patients with prostate-specific antigen (PSA)-only recurrent prostate cancer (PCa) following radical prostatectomy (RP) are controversial. We investigated the impact of early versus delayed ADT on survival outcomes in patients with non-metastatic, localized or locally advanced PCa who received radiation therapy (RT) following RP and later developed distant metastasis. MATERIALS AND METHODS: A retrospective analysis was performed on 69 patients with non-metastatic, localized or locally advanced PCa who received RT following RP and later developed distant metastasis between January 2006 and December 2012. Patients were stratified according to the level of PSA at which ADT was administered (<2 ng/mL vs. ≥2 ng/mL). Study endpoints were progression to castration-resistant prostate cancer (CRPC)-free survival and cancer-specific survival (CSS). RESULTS: Patients were stratified according to the criteria of 2 ng/mL of PSA at which ADT was administered, based on the Youden sensitivity analysis. Delayed ADT at PSA ≥2 ng/mL was an independent prognosticator of cancer-specific mortality (p=0.047), and a marginally significant prognosticator of progression to CRPC (p=0.051). During the median follow-up of 81.0 (interquartile range 54.2–115.7) months, patients who received early ADT at PSA <2 ng/mL had significantly higher CSS rates compared to patients who received delayed ADT at PSA ≥2 ng/mL (p=0.002). Progression to CRPC-free survival was comparable between the two groups (p=0.331). CONCLUSION: Early ADT at the PSA level of less than 2 ng/mL confers CSS benefits in patients with localized or locally advanced PCa who were previously treated with RP.
format Online
Article
Text
id pubmed-7393290
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Yonsei University College of Medicine
record_format MEDLINE/PubMed
spelling pubmed-73932902020-08-10 Optimal PSA Threshold for Androgen-Deprivation Therapy in Patients with Prostate Cancer following Radical Prostatectomy and Adjuvant Radiation Therapy Ahn, Hyun Kyu Lee, Kwang Suk Kim, Daeho Rha, Koon Ho Hong, Sung Joon Chung, Byung Ha Koo, Kyo Chul Yonsei Med J Original Article PURPOSE: The benefits of early administration of androgen-deprivation therapy (ADT) in patients with prostate-specific antigen (PSA)-only recurrent prostate cancer (PCa) following radical prostatectomy (RP) are controversial. We investigated the impact of early versus delayed ADT on survival outcomes in patients with non-metastatic, localized or locally advanced PCa who received radiation therapy (RT) following RP and later developed distant metastasis. MATERIALS AND METHODS: A retrospective analysis was performed on 69 patients with non-metastatic, localized or locally advanced PCa who received RT following RP and later developed distant metastasis between January 2006 and December 2012. Patients were stratified according to the level of PSA at which ADT was administered (<2 ng/mL vs. ≥2 ng/mL). Study endpoints were progression to castration-resistant prostate cancer (CRPC)-free survival and cancer-specific survival (CSS). RESULTS: Patients were stratified according to the criteria of 2 ng/mL of PSA at which ADT was administered, based on the Youden sensitivity analysis. Delayed ADT at PSA ≥2 ng/mL was an independent prognosticator of cancer-specific mortality (p=0.047), and a marginally significant prognosticator of progression to CRPC (p=0.051). During the median follow-up of 81.0 (interquartile range 54.2–115.7) months, patients who received early ADT at PSA <2 ng/mL had significantly higher CSS rates compared to patients who received delayed ADT at PSA ≥2 ng/mL (p=0.002). Progression to CRPC-free survival was comparable between the two groups (p=0.331). CONCLUSION: Early ADT at the PSA level of less than 2 ng/mL confers CSS benefits in patients with localized or locally advanced PCa who were previously treated with RP. Yonsei University College of Medicine 2020-08-01 2020-07-28 /pmc/articles/PMC7393290/ /pubmed/32734728 http://dx.doi.org/10.3349/ymj.2020.61.8.652 Text en © Copyright: Yonsei University College of Medicine 2020 https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Ahn, Hyun Kyu
Lee, Kwang Suk
Kim, Daeho
Rha, Koon Ho
Hong, Sung Joon
Chung, Byung Ha
Koo, Kyo Chul
Optimal PSA Threshold for Androgen-Deprivation Therapy in Patients with Prostate Cancer following Radical Prostatectomy and Adjuvant Radiation Therapy
title Optimal PSA Threshold for Androgen-Deprivation Therapy in Patients with Prostate Cancer following Radical Prostatectomy and Adjuvant Radiation Therapy
title_full Optimal PSA Threshold for Androgen-Deprivation Therapy in Patients with Prostate Cancer following Radical Prostatectomy and Adjuvant Radiation Therapy
title_fullStr Optimal PSA Threshold for Androgen-Deprivation Therapy in Patients with Prostate Cancer following Radical Prostatectomy and Adjuvant Radiation Therapy
title_full_unstemmed Optimal PSA Threshold for Androgen-Deprivation Therapy in Patients with Prostate Cancer following Radical Prostatectomy and Adjuvant Radiation Therapy
title_short Optimal PSA Threshold for Androgen-Deprivation Therapy in Patients with Prostate Cancer following Radical Prostatectomy and Adjuvant Radiation Therapy
title_sort optimal psa threshold for androgen-deprivation therapy in patients with prostate cancer following radical prostatectomy and adjuvant radiation therapy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7393290/
https://www.ncbi.nlm.nih.gov/pubmed/32734728
http://dx.doi.org/10.3349/ymj.2020.61.8.652
work_keys_str_mv AT ahnhyunkyu optimalpsathresholdforandrogendeprivationtherapyinpatientswithprostatecancerfollowingradicalprostatectomyandadjuvantradiationtherapy
AT leekwangsuk optimalpsathresholdforandrogendeprivationtherapyinpatientswithprostatecancerfollowingradicalprostatectomyandadjuvantradiationtherapy
AT kimdaeho optimalpsathresholdforandrogendeprivationtherapyinpatientswithprostatecancerfollowingradicalprostatectomyandadjuvantradiationtherapy
AT rhakoonho optimalpsathresholdforandrogendeprivationtherapyinpatientswithprostatecancerfollowingradicalprostatectomyandadjuvantradiationtherapy
AT hongsungjoon optimalpsathresholdforandrogendeprivationtherapyinpatientswithprostatecancerfollowingradicalprostatectomyandadjuvantradiationtherapy
AT chungbyungha optimalpsathresholdforandrogendeprivationtherapyinpatientswithprostatecancerfollowingradicalprostatectomyandadjuvantradiationtherapy
AT kookyochul optimalpsathresholdforandrogendeprivationtherapyinpatientswithprostatecancerfollowingradicalprostatectomyandadjuvantradiationtherapy