Correlation Between Prostate-specific Antigen Dynamics And Progression Time Of Castration-Resistant Prostate Cancer After Androgen Deprivation

Objective:In this study,a retrospective analysis was conducted to explore the relationship between the dynamic changes of PSA and the progression time of castrated-resistant prostate cancer(CRPC)after primary androgen deprivation therapy(PADT).Methods:121 prostate cancer patients who received PADT from 2009 to 2018 in The Second Affiliated Hospital of Nanchang University were enrolled.The Cox’s proportional hazards model were used to determine the predictive factors for prognosis rate of castration-resistant prostate cancer(CRPC).Research indicators contain: age,TNM stage,Gleason score,initial PSA,PSA nadir,and the PSA < 1ng/ml,PSA < 0.2ng/ml and PSA nadir,bone metastasis EOD score.Optimal cutoff values for PSA nadir and TTN on survival were calculated with the receiver operating characteristic(ROC)curve.Patients were stratified into unfavorable(higher PSA nadir and/or shorter TTN)and favorable(lower PSA nadir and longer TTN)groups.The Kaplan-Meier method was used for survival analysis.Logistic regression analysis compared the effects.Results:Median age and follow-up period were 74 years and 16.17 months,respectively.The multivariable analysis showed that bone metastasis EOD score(Hazard ratio [HR]:1.645;95% confidence interval [C.I.],1.116-2.424),nadir PSA<1ng/ml(HR: 0.379;95% C.I.,0.159-0.779),nadir PSA<0.2ng/ml(HR:0.383;95% C.I.,0.188-0.779),time from PADT to PSA<1ng/ml(<3 month(HR:0.496;95% C.I.,0.267-0.921)、 <5month(HR:0.398;95% C.I.,0.227-0.696)),time from PADT to PSA<0.2ng/ml(<6 month(HR:0.512;95% C.I.,0.277-0.947)、<9month(HR:0.423;95% C.I.,0.237-0.755)),time from PADT to nadir(HR:0.824;95% C.I.,0.770-0.883)were independent prognostic factors of the incidence of CRPC.ROC curve analysis demonstrated cutoffs of PSA nadir > 0.16 ng/mL and TTN < 9.08 months.The unfavorable group significantly shorter time to CRPC.Conclusion:Time from PADT to nadir and PSA nadir(<1ng/ml,<0.2ng/ml),time from PADT to PSA<1ng/ml(<3 month,<5month),time from PADT to PSA<0.2ng/ml(<6 month,<9month)and bone metastasis EOD score were factors that affect.Lower nadir PSA level,lower EOD score of bone metastasis,shorter time from PADT to PSA<1ngml and PSA<0.2ng/ml and longer time from PADT to nadir were good for progression.