初期治療として内分泌療法を行った前立腺癌 Stage D2における予後因子の検討

BACKGROUND: In order to make clear the prognostic factors in patients with advanced prostatic cancer (stage D2) whose initial treatment was hormone therapy, we reviewed 34 men with newly diagnosed advanced prostatic cancer for 6 years from May 1987 at the Hospital of Hokkaido University. METHODS: All patients had histologically proven prostatic adenocarcinoma. The mean age was 67.9 years (range 54 to 86 years). Median follow-up period was 26 months (range 5 to 66 months). The parameters studied were age, performance status, histological grade, extent of disease on bone scan, pretreatment values of PSA, gamma-Sm, PAP and PSA/gamma-Sm ratio, posttreatment values of PSA, gamma-Sm and PAP at 6th month, and the ratio of PSA at 3rd month to PSA at 6th month. RESULTS: Univariate analysis revealed that performance status (PSO vs. PS2, p = 0.006, PS1 vs. PS2, p = 0.016) and extent of disease on bone scan (p = 0.004) in background factors, gamma-Sm (p = 0.005) among pretreatment values of markers, PAP at 6th month (p < 0.001) and the ratio of PSA at 3rd month to PSA at 6th month (p < 0.001) among posttreatment values of markers, significantly related with the cause-specific survival. Based on multivariable analysis, PAP at 6th month and the ratio of PSA at 3rd month to PSA at 6th month were significantly correlated with the cause-specific survival at 24th month and 36th month, respectively. CONCLUSION: We conclude that posttreatment values of markers are more important prognostic factors in patients with advanced prostatic cancer (stage D2) following hormone therapy than pretreatment background factors and values of markers.