[Dynamics of prostate-specific antigen as prognostic factors in endocrine treatment for prostate cancer]

Prostate-specific antigen values provide important and unique information about prostate cancer to clinicians. However, there is conflicting information about the prognostic significance of the dynamics of PSA decline and elevation after treatment. To provide further insight into the dynamics of PSA as prognostic factors, we herein studied various PSA values as possible prognostic factors in 93 patients with prostate cancer treated with endocrine therapy. Thirteen (14.0%) had stage B tumors, 20 (21.5%) had stage C tumors, and 60 (64.5%) had stage D tumors. The overall 5-year survival rate was 41.2%. Relapse was observed in 32 (34.4%) patients. The influence of pre- and post-treatment PSA (both absolute and percentage values) on survival was analyzed. Normalization of PSA value was associated with prolonged survival regardless of interval to reach the lowest PSA level. The absolute value of PSA at 3 or 6 months following treatment was a significant discriminator, while the pre-treatment PSA level and percentage values of post-treatment PSA were not. These data show that the PSA nadir and PSA value at 3 or 6 months following treatment provide important prognostic information.