Serial tissue polypeptide specific antigen determinations in followup of hormone treated carcinoma of prostate.

Purpose: We determined, the impact of serum cytokeratin-18-related tissue polypeptide specific antigen (TPS) in monitoring hormone treated carcinoma of the prostate. Materials and Methods: From 1991 to 1996, serial TPS and prostate specific antigen (PSA) determinations (3,882) in 443 hormone treated prostate carcinoma patients were correlated with the clinical course for a mean of 22 months. Results: Elevated TPS levels were significantly associated with disease progression in hormone treated stage M1 carcinoma of the prostate (p = 0.001), even in high grade, PSA negative tumors. Post-therapy TPS declines following secondline therapy in hormone refractory prostate cancer patients (92) correlated significantly with. subjective response (p = 0.001, PSA p = 0.02) and progression-free survival time (r(s) = -0.76, PSA r(s) = -0.32). A TPS decrease of more than 50% coincided with palliation in 90% of patients (PSA 64%) and predicted the best chance of a longer progression of free survival (p <0.00005, PSA p = 0.036). Vice versa, rising TPS levels (more than 20%) coincided with subjective response in only 1 of 37 patients (PSA 9 of 33). Conclusions: TPS may be a useful adjunct to PSA in monitoring hormone refractory, metastasized prostate cancer.