| Summary: | 碩士 === 國立臺灣大學 === 預防醫學研究所 === 97 === Background and Objectives: The prognosis of men with advanced prostate cancer receiving androgen deprivation therapy is highly variable, and it is difficult to counsel a man who is in non-curative treatments. The aim of this study is to identify prognostic factors affecting biochemical progression (BCP) of advanced prostate cancer patients in Taiwan.
Methods: Working with 2 medical centers within north Taiwan, a cohort of men diagnosed with prostate adenocarcinoma ever receiving leuprorelin acetate (Leuplin Depot®, 3.75 mg) between November 1995 and April 2008 was collected from the computerized registry system of the two medical centers. A total of 107 eligible patients with newly diagnosed advanced (cT3 above) or metastatic prostate cancer were assessed for the development of BCP and overall survival. All men had initial serum prostate specific antigen (PSA) measurements. Cox regression model and Kaplan-Meier analysis were used to evaluate the relationship between the clinical parameters and the BCP.
Results: The median age of the included men was 74.6 years. The median value of initial PSA was 105 ng/mL (Q1-Q3, 39.8 to 372 ng/mL). A total of 54 patients (50.5%) had BCP during a median 46.1 months’ follow-up. In a multivariate analysis, initial serum PSA greater than 105 ng/mL (relative risk [RR], 3.23; 95% confidence interval [CI], 1.66, 6.29), pathological bone fracture (RR, 2.73; 95% CI, 1.37, 5.44), and hemoglobin 12.7 g/dL or less (RR, 2.05; 95% confidence interval, CI, 1.10, 3.81) were prognostic factors of BCP. As compared with those in the lowest tertile, participants in the highest tertile of initial PSA had nearly 3 times the age and body mass index (BMI)-adjusted risk of BCP (RR, 3.16; 95% CI, 1.38, 7.22). Further adjustment for prostate volume, method of diagnosis, Gleason score, bone metastasis and pathologic bone fracture slightly attenuated the risk. However, after adjusting for hemoglobin and the clinical diseases, the relative risk of developing BCP remained significant (RR, 3.68; 95% CI, 1.33 to 10.0).
Conclusions: Our data demonstrate that initial serum PSA is a significant risk factor for BCP for Taiwanese advanced prostate cancer patients.
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