Teoh Jeremy Yuen Chun, Tsu James Hok Leung, Yuen Steffi Kar Kei, Chan Samson Yun Sang, Chiu Peter Ka Fung, Wong Ka-Wing, Ho Kwan-Lun, Hou Simon See Ming, Ng Chi-Fai, Yiu Ming Kwong
Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
Asia Pac J Clin Oncol. 2017 Apr;13(2):e65-e71. doi: 10.1111/ajco.12313. Epub 2014 Dec 3.
To evaluate the progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS) of Chinese metastatic prostate cancer patients following primary androgen deprivation therapy (ADT) in relation to prostate-specific antigen (PSA) nadir level.
All Chinese prostate cancer patients with bone metastases who were treated with primary ADT from 2000 to 2009 were included. Patients' and disease characteristics were recorded. Patients were categorized into two PSA nadir groups (≤1.0 and >1.0 ng/mL). Associations of PSA nadir with PFS, CSS and OS were analyzed with Kaplan-Meier and Cox regression analyses. The survival outcomes of the two PSA nadir groups were presented.
Four hundred nineteen patients were included in the study. PSA nadir appeared to be a good predictor for PFS (hazard ratio [HR] 1.86, 95% confidence interval [CI] 1.35-2.56, P < 0.001), CSS (HR 1.60, 95% CI 0.98-2.64, P = 0.063) and OS (HR 1.77, 95% CI 1.20-2.41, P < 0.001) upon multivariate Cox regression analyses. In the PSA nadir groups of ≤1.0 and >1.0 ng/mL, the median PFS were 15 and 10 months, and the 1-year PFS rates were 64% and 40%, respectively; the median CSS were 42 and 27 months, and the 5-year OS rates were 53% and 28%, respectively; and the median OS were 41 and 24 months, and the 5-year OS rates were 45% and 19%, respectively.
Higher PSA nadir was associated with shorter PFS, CSS and OS in Chinese metastatic prostate cancer patients following primary ADT. The survival outcomes may serve as references in deciding the best treatment strategy in Chinese prostate cancer patients.
评估中国转移性前列腺癌患者在接受初始雄激素剥夺治疗（ADT）后，无进展生存期（PFS）、癌症特异性生存期（CSS）和总生存期（OS）与前列腺特异性抗原（PSA）最低点水平的关系。
纳入2000年至2009年期间接受初始ADT治疗的所有中国骨转移前列腺癌患者。记录患者和疾病特征。患者被分为两个PSA最低点组（≤1.0和>1.0 ng/mL）。采用Kaplan-Meier法和Cox回归分析PSA最低点与PFS、CSS和OS的相关性。呈现两个PSA最低点组的生存结果。
419例患者纳入研究。多因素Cox回归分析显示，PSA最低点似乎是PFS（风险比[HR] 1.86，95%置信区间[CI] 1.35 - 2.56，P < 0.001）、CSS（HR 1.60，95% CI 0.98 - 2.64，P = 0.063）和OS（HR 1.77，95% CI 1.20 - 2.41，P < 0.001）的良好预测指标。在PSA最低点≤1.0 ng/mL和>1.0 ng/mL组中，中位PFS分别为15个月和10个月，1年PFS率分别为64%和40%；中位CSS分别为42个月和27个月，5年OS率分别为53%和28%；中位OS分别为41个月和24个月，5年OS率分别为45%和19%。
在中国转移性前列腺癌患者接受初始ADT后，较高的PSA最低点与较短的PFS、CSS和OS相关。这些生存结果可为中国前列腺癌患者制定最佳治疗策略提供参考。
