RESPONSE OF PROSTATE-SPECIFIC ANTIGEN AFTER ANDROGEN WITHDRAWAL AND PROGNOSIS IN MEN WITH METASTATIC PROSTATE-CANCER

Objective: Patients with prostate cancer generally respond to androgen withdrawal therapy, but progression to androgen independence is frequ ently observed. To evaluate prognostic factors in metastatic prostate cancer, patients who had been treated with endocrine therapy were inve stigated. Methods: One hundred and thirty-nine patients with untreated metastatic prostate cancer (TxNxM1)who received endocrine therapy bet ween 1986 and 1993 were included in the present study. Blood chemistry , histological grade, extent of bony metastases, clinical response to hormone therapy, and the prognosis of the patients were evaluated. Res ults: With univariate analysis, performance status. hemoglobin concent ration, serum alkaline phosphatase, lactate dehydrogenase, histologica l grade, extent of bony disease, and response of prostate-specific ant igen (PSA) at 3 months were shown to be significant prognostic factors . With multivariate analyses, response of PSA and histological grade w ere significant factors predicting prognosis. Conclusions: Patients wh ose PSA had not normalized 3 months after the start of endocrine thera py were in the high-risk group, and should be given more aggressive tr eatment.