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By E. R. Babaev, V. B. Matveev and M. I. Volkova


<p><strong>Background and objective. </strong>The division of patients with disseminated prostate cancer (PC) into prognostic groups may be potentially used for a differential approach to choosing the hormonal therapy (HT) option and regimen. This study was conducted to identify factors influencing survival, as well as prognostic groups in this category of patients.</p><p><strong>Subjects. </strong>The study enrolled 113 patients with verified cT2b–4N0–1M0–1 stage PC. Their median age was 70.0 ± 7.3 years. The median pretreatment prostate-specific antigen (PSA) concentration was 309.8 ng/ml. The stage cT2 was diagnosed in 12 (10.6 %) patients; cT3 was in 85 (75.2 %); cT4 in 16 (14.2 %); cN+ in 32 (28.3 %); М+ in 74 (65.5 %). The median baseline Gleason score was 3.0± 0.8 ± 4.0± 0.9 =7.0± 1.6. All the patients received emergency HT: castration was carried out in 2 (1.8 %) patients; maximum androgenic block and antiandrogen monotherapy were performed in 96 (85.0 %) and 15 (13.3 %), patients, respectively. The median follow-up was 31.9± 17.7 months.</p><p><strong>Results. </strong>Five-year progression-free, hormone-refractory prostate cancer-free, specific, and overall survivals (OS) were 29.7, 31.8, 39.3, and 26.0 %, respectively. Multivariate analysis has shown that OS is negatively influenced by the following factors: bone pain, stages cT4, М+, a nadir of PSA of  4 ng/ml (p &lt; 0.05) and its baseline level of  100 ng/ml (р = 0.057). Good (no bone pain, a PSA level of &lt; 100 ng/ml, сТ &lt; T4, and М0) and poor (bone pain and/or a PSA level of  100 ng/ml, and/or stages cT4 and/or М+) prognostic groups were identified. The median OS in the groups was 39.8± 3.9 and 29.8± 4.2 months, respectively (р = 0.048).</p><p><strong>Conclusion. </strong>In disseminated PC, bone pain, a PSA level of 100 ng/ml, cT4 and M+, and a PSA nadir of  4 ng/ml are poor predictors of OS. The patients without these indicators belong to a good prognostic group; those have one sign or more do to a poor prognostic one.</p

Topics: predictor, overall survival, hormonal therapy, Medicine, R
Publisher: ABV-press
Year: 2011
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