Journal List > Korean J Urol > v.47(4) > 1069865

Yoon: Free PSA and the Free PSA to Total PSA Ratio as a Predictor of Response to Hormone Treatment for Metastatic Prostate Cancer

Abstract

Purpose

In this study we analyzed the changes of fPSA and f-PSA% and its prognostic significance in course of hormone treatment for metastatic prostate cancer.

Materials and Methods

We retrospectively analyzed 75 patients with metastatic prostate cancer who received maximal androgen deprivation therapy and in whom the fPSA and f-PSA% had been serially checked for at least 1 year. The patients were divided into two groups: those patients with biological recurrence within 1 year, and those patients showing sensitivity to hormone therapy for longer than one year. Changes of the fPSA and f-PSA% in each group were analyzed in correlation with such prognostic factors as the PSA level and the Gleason sum.

Results

The initial PSA levels in each group were 508.0±331.4ng/ml and 39.8±7.6ng/ml, respectively and the fPSA levels were 59.4±19.4ng/ml and 6.7±4.1ng/ml, respectively; the group with early biological recurrence had significantly higher intial PSA and fPSA levels. The initial f-PSA% was relatively lower in the patients with early recurrence (0.123±0.41 vs 0.159±0.37, respectively), but the difference was not statistically significant. The PSA nadir and the fPSA nadir in the early recurrence group were 6.1±10.1ng/ml and 0.89±3.9ng/ml, respectively, and these were significantly higher compared to those values of the hormone sensitive group, i.e., 2.4±8.4ng/ml and 0.41±0.2ng/ml, respectively. In the early recurrence group, the f-PSA% changed from 0.123 to 0.092 and it gradually decreased during treatment. On the contrary, in the hormone sensitive group, the f-PSA% continuously increased during treatment, from 0.159 to 0.172.

Conclusions

These findings suggest that fPSA and f-PSA% are influenced by hormone treatment and the pattern of changes in the fPSA and f-PSA% are different according to the responsiveness to hormone treatment.

Figures and Tables

Table 1
Characteristics of the patients
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*maximal androgen blockade. Group I: patients with biological recurrence within 1 year of hormone treatment, Group II: patients showing sensitivity to hormone treatment longer than 1 year

Table 2
PSA, fPSA and f-PSA% in each group
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PSA: prostate-specific antigen

Table 3
Changes of PSA, fPSA and f-PSA% during hormone treatment
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PSA: prostate-specific antigen

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