前立腺癌における内分泌療法後の前立腺特異抗原の変動と予後

Abstract

内分泌療法を施行した前立腺癌患者93例を対象に前立腺特異抗原(PSA)の変動と予後の関連を中心とした臨床的検討を行った. 1)治療開始前PSA値による予後の差は燃められなかった.stage C以上のhigh stage群でも有意差を認めなかった. 2)治療開始後のPSA値の経時的推移では, 3ヵ月後, 6ヵ月後のPSAの正常化が良好な予後因子であると思われた.1ヵ月後のPSA値と予後の間には相関はなかった. 3)治療過程におけるPSA値の正常化は, 正常化する迄の期間を問わず良好な予後因子であった. 4)最低値到達時間と予後の間に相関は認められなかった

Prostate-specific antigen values provide important and unique information about prostate cancer to clinicians. However, there is conflicting information about the prognostic significance of the dynamics of PSA decline and elevation after treatment. To provide further insight into the dynamics of PSA as prognostic factors, we herein studied various PSA values as possible prognostic factors in 93 patients with prostate cancer treated with endocrine therapy. Thirteen (14.0%) had stage B tumors, 20 (21.5%) had stage C tumors, and 60 (64.5%) had stage D tumors. The overall 5-year survival rate was 41.2%. Relapse was observed in 32 (34.4%) patients. The influence of pre- and post-treatment PSA (both absolute and percentage values) on survival was analyzed. Normalization of PSA value was associated with prolonged survival regardless of interval to reach the lowest PSA level. The absolute value of PSA at 3 or 6 months following treatment was a significant discriminator, while the pre-treatment PSA level and percentage values of post-treatment PSA were not. These data show that the PSA nadir and PSA value at 3 or 6 months following treatment provide important prognostic information.