PROSTATE-SPECIFIC ANTIGEN AS A PRETHERAPY PROGNOSTIC FACTOR IN PATIENTS TREATED WITH RADIATION-THERAPY FOR CLINICALLY LOCALIZED PROSTATE-CANCER

被引:112
作者
PISANSKY, TM [1 ]
CHA, SS [1 ]
EARLE, JD [1 ]
DURR, ED [1 ]
KOZELSKY, TF [1 ]
WIEAND, HS [1 ]
OESTERLING, JE [1 ]
机构
[1] MAYO CLIN & MAYO FDN, DEPT UROL, ROCHESTER, MN 55905 USA
关键词
D O I
10.1200/JCO.1993.11.11.2158
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: This study was conducted to determine the value of prostate- specific antigen (PSA) as a pretherapy prognostic factor for localized prostate cancer treated with primary irradiation (RT). Patients and Methods: Between March 1987 and December 1990, 254 patients with pretherapy PSA determinations were treated for clinical stage A2 to C prostate adenocarcinoma. In conjunction with other prognostic factors, pretherapy PSA was evaluated to determine whether it had independent predictive value for disease outcome. Results: Pretherapy PSA was highly and directly correlated with clinical stage, tumor grade, and acid phosphatase level. With a median follow-up duration of 24 months, 241 patients (95%) were fully assessable for disease outcome. In these patients, PSA and tumor grade were the sole independent predictive factors for tumor relapse (ie, clinically determined and/or increasing PSA level). The combination of pretherapy PSA and tumor grade information defined groups of patients with distinctly different outcome. For patients in low- (favorable PSA and tumor grade), intermediate- (favorable PSA or tumor grade), and high- (adverse PSA and tumor grade) risk categories, the actuarial rates of survival free of tumor relapse or increasing PSA level were 94%, 77%, and 42% at 3 years, respectively (P < .0001). Conclusion: Pretherapy PSA is a strongly independent prognostic factor for disease outcome following primary RT. The combination of adverse pretherapy PSA and unfavorable tumor grade identified a cohort of patients with a high risk of early treatment failure in whom combined modality therapy may be appropriately investigated.
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收藏
页码:2158 / 2166
页数:9
相关论文
共 58 条
  • [1] THE NATURAL COURSE OF LOW-GRADE, NONMETASTATIC PROSTATIC-CARCINOMA
    ADOLFSSON, J
    RONSTROM, L
    CARSTENSEN, J
    LOWHAGEN, T
    HEDLUND, PO
    [J]. BRITISH JOURNAL OF UROLOGY, 1990, 65 (06): : 611 - 614
  • [2] BABAIAN RJ, 1991, CANCER-AM CANCER SOC, V67, P2200, DOI 10.1002/1097-0142(19910415)67:8<2200::AID-CNCR2820670833>3.0.CO
  • [3] 2-E
  • [4] BADALAMENT RA, 1991, CANCER, V67, P3014, DOI 10.1002/1097-0142(19910615)67:12<3014::AID-CNCR2820671215>3.0.CO
  • [5] 2-U
  • [6] Beahrs OH, 1988, MANUAL STAGING CANC, P177
  • [7] CANCER STATISTICS, 1993
    BORING, CC
    SQUIRES, TS
    TONG, T
    [J]. CA-A CANCER JOURNAL FOR CLINICIANS, 1993, 43 (01) : 7 - 26
  • [8] SCREENING FOR PROSTATIC-CARCINOMA WITH PROSTATE SPECIFIC ANTIGEN
    BRAWER, MK
    CHETNER, MP
    BEATIE, J
    BUCHNER, DM
    VESSELLA, RL
    LANGE, PH
    [J]. JOURNAL OF UROLOGY, 1992, 147 (03) : 841 - 845
  • [9] MEASUREMENT OF PROSTATE-SPECIFIC ANTIGEN IN SERUM AS A SCREENING-TEST FOR PROSTATE-CANCER
    CATALONA, WJ
    SMITH, DS
    RATLIFF, TL
    DODDS, KM
    COPLEN, DE
    YUAN, JJJ
    PETROS, JA
    ANDRIOLE, GL
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1991, 324 (17) : 1156 - 1161
  • [10] COX DR, 1972, J R STAT SOC B, V34, P187