PSA decline is an independent prognostic marker in hormonally treated prostate cancer

Objective: The aim of this study was to estimate the prevalence of primary hormone-refractory prostate cancer and to evaluate the prognostic value of decline of prostate-specific antigen (PSA) after primary hormonal therapy M aterial and Methods: The material consisted of 236 consecutive, hormonally treated prostate cancer patients, whose clinicopathological findings, as we ll as serum PSA values, were retrieved from patient files. Multivariate ana lysis was performed based on the PSA decline at 12 months from the commence ment of therapy and patients were thereafter categorised into four groups: complete response (CR), partial response (PR), stable disease (SD), and no response (NR) according to the biochemical response. Results: Only 14 (5.9% ) of the patients were included in the NR group, i.e. PSA declined less tha n 50%, suggesting that primary androgen-independent prostate cancer is unco mmon. The PSA decline was significantly (p < 0.001) associated with cancer- specific survival. Patients with CR had a median survival of more than 6 ye ars, whereas those with NR had a median survival of only 14 months. In mult ivariate analysis, PSA decline showed independent prognostic value together with M-stage and histological grade. Conclusions: Primary prostate cancer is probably even more sensitive to hormonal treatment than previously assum ed, and PSA decline seems to be useful in predicting disease outcome after hormonal therapy.