Prognostic factors in metastatic prostate cancer

H. Matzkin, P. E. Perito, M. S. Soloway

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Androgen deprivation therapy is the initial treatment choice for metastatic disease. When enrolling patients into androgen deprivation trials, it is important to consider stratification of enrollees based on prognostic factors that have been identified as important in determining the likelihood of response. Prognostic factors are also helpful in identifying which patients are less likely to respond to treatment; this information also would help to counsel patients. Performance status is an important prognostic factor; however, its impact is minimal because the great majority of men who receive treatment for advanced disease have a normal performance status. Hemoglobin, alkaline phosphatase, and a semiquantitative grading scale for the number of metastatic foci on the bone scan are useful prognostic factors. The pretreatment serum testosterone level is a powerful prognostic factor. Patients with a low serum testosterone level have a shorter progression-free survival than men whose pretreatment serum testosterone level is above normal. The prognostic importance of pretreatment serum testosterone level has been evaluated in studies using treatment methods that lower this level to castrate levels. Recently, we found that serum testosterone level was not a prognostic factor for men taking the nonsteroidal antiandrogen, Casodex (Zeneca, Wilmington, DE), which does not alter the serum testosterone level. The pretreatment serum prostatic-specific antigen also is a prognostic factor. This antigen may be the best single method for monitoring patients in regard to response to or progression following therapy. The return of the prostatic-specific antigen level to normal (<4 ng/ml), or the decline in the prostatic-specific antigen level of >90% indicates a prolonged progression- free survival. In the future, it will be interesting to incorporate both the initial prognostic factors as well as monitor the prostatic-specific antigen into a multivariate analysis, which will be highly predictive of a man's response to treatment.

Original languageEnglish
Pages (from-to)3788-3792
Number of pages5
JournalCancer
Volume72
Issue number12 SUPPL.
StatePublished - Jan 1 1993
Externally publishedYes

Fingerprint

Prostatic Neoplasms
Testosterone
Serum
Antigens
Therapeutics
Androgens
Disease-Free Survival
Nonsteroidal Anti-Androgens
Physiologic Monitoring
Alkaline Phosphatase
Hemoglobins
Multivariate Analysis
Bone and Bones

Keywords

  • prognostic factors
  • prostate cancer
  • prostate specific antigen

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Matzkin, H., Perito, P. E., & Soloway, M. S. (1993). Prognostic factors in metastatic prostate cancer. Cancer, 72(12 SUPPL.), 3788-3792.

Prognostic factors in metastatic prostate cancer. / Matzkin, H.; Perito, P. E.; Soloway, M. S.

In: Cancer, Vol. 72, No. 12 SUPPL., 01.01.1993, p. 3788-3792.

Research output: Contribution to journalArticle

Matzkin, H, Perito, PE & Soloway, MS 1993, 'Prognostic factors in metastatic prostate cancer', Cancer, vol. 72, no. 12 SUPPL., pp. 3788-3792.
Matzkin H, Perito PE, Soloway MS. Prognostic factors in metastatic prostate cancer. Cancer. 1993 Jan 1;72(12 SUPPL.):3788-3792.
Matzkin, H. ; Perito, P. E. ; Soloway, M. S. / Prognostic factors in metastatic prostate cancer. In: Cancer. 1993 ; Vol. 72, No. 12 SUPPL. pp. 3788-3792.
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