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KMID : 0358320060470040362
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Korean Journal of Urology
2006 Volume.47 No. 4 p.362 ~ p.367
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Free PSA and the Free PSA to Total PSA Ratio as a Predictor of Response to Hormone Treatment for Metastatic Prostate Cancer
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Yoon Cheol-Yong
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Abstract
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Purpose: In this study we analyzed the changes of fPSA and f-PSA% and its prognostic significance in course of hormone treatment for metastatic prostate cancer.
Materials and Methods: We retrospectively analyzed 75 patients with metastatic prostate cancer who received maximal androgen deprivation therapy and in whom the fPSA and f-PSA% had been serially checked for at least 1 year. The patients were divided into two groups: those patients with biological recurrence within 1 year, and those patients showing sensitivity to hormone therapy for longer than one year. Changes of the fPSA and f-PSA% in each group were analyzed in correlation with such prognostic factors as the PSA level and the Gleason sum.
Results: The initial PSA levels in each group were 508.0±331.4ng/ml and 39.8±7.6ng/ml, respectively and the fPSA levels were 59.4±19.4ng/ml and 6.7±4.1ng/ml, respectively; the group with early biological recurrence had significantly higher intial PSA and fPSA levels. The initial f-PSA% was relatively lower in the patients with early recurrence (0.123±0.41 vs 0.159±0.37, respectively), but the difference was not statistically significant. The PSA nadir and the fPSA nadir in the early recurrence group were 6.1±10.1ng/ml and 0.89±3.9ng/ml, respectively, and these were significantly higher compared to those values of the hormone sensitive group, i.e., 2.4±8.4ng/ml and 0.41±0.2ng/ml, respectively. In the early recurrence group, the f-PSA% changed from 0.123 to 0.092 and it gradually decreased during treatment. On the contrary, in the hormone sensitive group, the f-PSA% continuously increased during treatment, from 0.159 to 0.172.
Conclusions: These findings suggest that fPSA and f-PSA% are influenced by hormone treatment and the pattern of changes in the fPSA and f-PSA% are different according to the responsiveness to hormone treatment. (Korean J Urol 2006;47:362-367)
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KEYWORD
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Prostate-specific antigen, Prostate cancer, Hormone replacement therapy
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