Furuya Y, Akimoto S, Akakura K, Igarashi T, Murakami S, Shimazaki J, Ito H
Department of Urology, Chiba University, School of Medicine, Asahi General Hospital, Chiba, Japan.
Urol Int. 1998;60(1):28-32. doi: 10.1159/000030199.
Patients with prostate cancer generally respond to androgen withdrawal therapy, but progression to androgen independence is frequently observed. To evaluate prognostic factors in metastatic prostate cancer, patients who had been treated with endocrine therapy were investigated.
One hundred and thirty-nine patients with untreated metastatic prostate cancer (TxNxM1) who received endocrine therapy between 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.
With univariate analysis, performance status, hemoglobin concentration, serum alkaline phosphatase, lactate dehydrogenase, histological grade, extent of bony disease, and response of prostate-specific antigen (PSA) at 3 months were shown to be significant prognostic factors. With multivariate analyses, response of PSA and histological grade were significant factors predicting prognosis.
Patients whose PSA had not normalized 3 months after the start of endocrine therapy were in the high-risk group, and should be given more aggressive treatment.
前列腺癌患者通常对雄激素剥夺疗法有反应，但雄激素非依赖性进展却屡见不鲜。为评估转移性前列腺癌的预后因素，对接受过内分泌治疗的患者展开了调查。
本研究纳入了1986年至1993年间接受内分泌治疗的139例未经治疗的转移性前列腺癌（TxNxM1）患者。对患者的血液生化指标、组织学分级、骨转移范围、激素治疗的临床反应及预后进行了评估。
单因素分析显示，体能状态、血红蛋白浓度、血清碱性磷酸酶、乳酸脱氢酶、组织学分级、骨病范围以及3个月时前列腺特异性抗原（PSA）的反应是显著的预后因素。多因素分析表明，PSA反应和组织学分级是预测预后的显著因素。
内分泌治疗开始3个月后PSA未恢复正常的患者属于高危组，应给予更积极的治疗。
