LACK OF CORRELATION BETWEEN PROSTATE-SPECIFIC ANTIGEN AND THE PRESENCE OF MEASURABLE SOFT-TISSUE METASTASES IN HORMONE-REFRACTORY PROSTATE-CANCER

Appropriate staging procedures for patients with hormone-refractory pr ostate cancer are poorly defined. In particular, there are no studies correlating prostate-specific antigen (PSA) with more traditional meth ods of staging. We have evaluated the abdominal/pelvic CT scan, bone s can, and PSA results following initial diagnosis of hormone-refractory prostate cancer in 177 consecutive patients (median age = 63.1 years, range 45-80). Thirty-four patients (19.2%) had measurable lesions (gr eater than or equal to 2 cm) on CT scan compatible with metastatic dis ease. Of the patients with measurable lesions, 29/34 (85.3%) had retro peritoneal and/or pelvic adenopathy; 5 patients (14.7%) had measurable lesions in the liver. Other sites of metastatic disease were detected in less than 1% of the patients receiving scans. All patients had bon e scan abnormalities compatible with metastatic disease. Results of th ese imaging studies were then compared to PSA serum concentration (Abb ott IMx). The mean PSA concentration was not different in those patien ts with soft tissue disease as compared to those without soft tissue i nvolvement and there was no correlation between PSA concentration and the presence or absence of measurable soft tissue disease. In contrast to previously published studies in hormone-naive prostate cancer pati ents, these studies in hormone-refractory patients indicate that the d etection of metastatic disease by standard radiological procedures can not be predicted by measurement of serum PSA.