The prostate specific antigen (PSA) is most valuable in monitoring the disease status and treatment response especially in patients with advanced metastatic adenocarcinoma of the prostate. Between January 1992 and August 1995, we longitudinally
followed
PSA levels din 29 patients with newly diagnosed metastatic prostat3e cancer who were treated with orchiectomy, orchiectomy plus antinadrogen daily, or gonadotropin-releasing hormone analogue monthly plus antimandrogen daily. The mean length of
follow up
and the mean age for the 19 patients who survived were 22 months and 70 years, for the 10 patients who expired were 23.8 months and 65 years. The mean value (±SD) of pre-treatment PSA level and post-treatment PSA level at 1 month were
213.5±395.1
ng/ml, 21.1±31.9 ng/ml in survival group and 128.9±112.3 ng/ml, 55.6±62.3 ng/ml in expired group, respectively. The mean value (±SD0 of nadir PSA level was 11.3±26.2 ng/ml in survival group and 18.4±21.2 ng/ml in expired group. The mean
value
(±SD0 of time to nadir PSA and time to PSA elevation were 166.2±156.0 days, 206±115 days in survival group and 278±180 of post-treatment PSA level at 1 month was higher and the mean value (±SD) of tiem to nadir PSA was longer in expired
group
than
survival group (p<0.05). Even though statistically significant differences were not noticed, there was a tendency to be higher nadir PSA level, shorter time to PSA elevation in expired group. Pre-treatment PSA level may not significantly
influence
survival. Further large-scaled prospective studles are needed to determine the significant role of the changes of PSA after androgen blocking in patients with metastatic prostate cancer.
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