Predictive clinical indicators of biochemical progression in advanced prostate cancer patients receiving leuplin depot as androgen deprivation therapy
Journal
PLoS ONE
Journal Volume
9
Journal Issue
8
Pages
e105091
Date Issued
2014
Author(s)
Abstract
Therapeutic planning and counseling for advanced prostate cancer patients receiving androgen deprivation therapy (ADT) is complicated because the prognoses are highly variable. The purpose of this study is to identify predictive clinical indicators of biochemical progression (BCP). In this retrospective analysis, data from 107 newly diagnosed patients (from November 1995 to April 2008) with advanced prostate adenocarcinoma receiving Leuprorelin acetate depot were analyzed. Data was collected from the computerized registry of two collaborating medical centers in Taiwan. Cox regression and Kaplan-Meier analyses were used to evaluate the relationship between potential predictive parameters and BCP. Univariate analysis revealed that predictors of BCP included (1) initial serum prostate-specific antigen (PSA) (hazard ratio [HR], 1.00; 95% confidence interval [CI] 1.00-1.00); (2) log of initial PSA (HR, 1.35; 95% CI 1.17-1.56); (3) PSA density at diagnosis (HR, 1.00; 95% CI 1.00-1.01), and (4) pathological bone fracture (HR, 2.22; 95% CI 1.20-4.11). Age (HR, 0.94; 95% CI 0.91-0.98) and hemoglobin levels (HR, 0.86; 95% CI 0.76-0.97) were also associated with greater risk of BCP. After adjusting for age, pathologic fracture, and hemoglobin level, the initial PSA and PSA density were no longer significantly associated with BCP. However, age and hemoglobin levels continued to be associated with greater risk of BCP (P#0.007). Using Kaplan-Meier analysis, patients with higher initial PSA concentration, pathological bone fracture, and low hemoglobin had a greater probability of BCP. Thus, low hemoglobin and age are predictive indicators of BCP and therefore early indicators of BCP despite ADT therapy. ? 2014 Chen et al.
SDGs
Other Subjects
antiandrogen; delayed release formulation; leuprorelin; prostate specific antigen; aged; blood; delayed release formulation; human; male; metabolism; middle aged; pathology; prognosis; proportional hazards model; Prostatic Neoplasms; very elderly; Aged; Aged, 80 and over; Androgen Antagonists; Delayed-Action Preparations; Humans; Leuprolide; Male; Middle Aged; Prognosis; Proportional Hazards Models; Prostate-Specific Antigen; Prostatic Neoplasms
Publisher
Public Library of Science
Type
journal article