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Abstract

Volume 11, Issue 4 (July 2009) 11, 443–450; 10.1038/aja.2008.36

Prostate-specific antigen half-life: a new predictor of progression-free survival and overall survival in Chinese prostate cancer patients

Guo-Wen Lin1,2,*, Xu-Dong Yao1,2,*, Shi-Lin Zhang1,2, Bo Dai1,2, Chun-Guang Ma1,2, Hai-Liang Zhang1,2, Yi-Jun Shen1,2, Yao Zhu1,2, Yi-Ping Zhu1,2, Guo-Hai Shi1,2, Xiao-Jian Qin1,2 and Ding-Wei Ye1,2

1 Department of Urology, Cancer Hospital, Fudan University, Shanghai 200032, China
2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China

* These two authors contributed equally to this paper.

Correspondence: Dr Ding-Wei Ye, E-mail: dwye@shca.org.cn

Received 8 August 2008; Revised 4 October 2008; Accepted 22 October 2008; Published online 2 February 2009

Abstract

We investigated the potential value of prostate-specific antigen half-life (PSAHL) and decreasing velocity (PSAVd) to predict progression-free survival (PFS) and overall survival (OS) in Chinese patients with prostate cancer. A total of 153 patients treated with hormonal therapy were included in the study. Of these, 78 patients progressed to hormone-refractory prostate cancer (HRPC) and 24 patients died by the end of follow-up. PSAHL was defined as the time during which prostate-specific antigen (PSA) concentration became half of the initial value during the first hormonal therapy. PSAVd reflected the decreasing velocity of PSA during the first hormonal therapy. PFS was defined as the interval from the beginning of hormonal therapy to HRPC. Cox proportional hazards regression analysis was used to evaluate whether PSAHL and PSAVd were significantly associated with PFS and OS. The median PSAHL and PSAVd were 0.50 months and 33.8 ng mL-1 per month. The median PFS and OS were 22.7 months (95% confidence interval [CI], 22.0–29.6 months) and 43.5 months (95% CI, 37.9–48.4 months), respectively. On univariate and multivariate analysis, long PSAHL (> 0.5 months), metastatic disease, high biopsy Gleason scores ( >8) and high nadir PSA (> 0.4 ng mL-1) were all found to be significantly associated with short PFS. Long PSAHL, high nadir PSA and short PSA doubling time (PSADT 2.0 months) were significantly associated with short OS. There were no significant relationships between PSAVd and either PFS or OS. Thus, PSAHL is a promising new independent predictor of survival. Patients with long PSAHL were identified as those at high risk for a relatively short PFS and OS.

Keywords: predictor, prognosis, prostate cancer, prostate-specific antigen decreasing velocity, prostate-specific antigen half-life

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