Neuroendocrine serum tumour markers in hormone-resistant prostate cancer

Objective: The primary aim of the study was to assess the prevalence of elevated serum levels of neuron-specific enolase (NSE) and chromogranin A (CgA) in hormone-resistant prostate cancer (HRPC), and to evaluate these markers' prognostic significance. Secondarily we wanted to assess any change in serum levels of NSE or CgA after palliative radiotherapy. Methods: Serum samples from patients with painful bone metastases or symptomatic pelvic tumours due to HRPC were analyzed for prostatespecific antigen (PSA), NSE and CgA before and after palliative radiotherapy. Results: Forty-six of 138 patients (33%) had elevated NSE before radiotherapy, while 80 (58%) had elevated CgA, without correlation between the two markers or with PSA. After radiotherapy the median NSE level was significantly reduced (p = 0.004), whereas CgA (p = 0.009) and PSA (p = 0.019) increased. In the multivariate survival analysis, a reduced performance status, >20 bone metastases on bone scan, low hemoglobin, and pre-radiotherapy elevated NSE levels indicated a short survival. Conclusion: Together with known clinical parameters, NSE predicts survival in patients with HRPC. NSE could become a valuable prognostic marker in patients with this condition. (C) 2003 Elsevier B.V. All rights reserved.