Ravi P, et al. - Experts ascertained the clinicopathologic factors related to early progression on androgen deprivation therapy (ADT) as well as cancer-specific (CSS) and overall survival (OS), and evaluate if certain prostate-specific antigen (PSA) thresholds at ADT initiation were associated with poorer outcomes. The adverse prognostic factors for early progression were PSA DT <3 months and PSA ≥5ng/ml and CSS – with PSA ≥5ng/ml also predicting shorter OS – in men initiating ADT for relapse after radical prostatectomy. An association of longer DT and PSA <5ng/ml with lower risk was noted and these men did not require immediate ADT.

Methods

• Authors identified 2,418 men with rising PSA after undergoing radical prostatectomy at a single institution between 1987-2007 from a prospectively-maintained registry.
• They defined the early progression as clinical progression within 2 years of initiating ADT.
• CSS and OS were the primary outcomes .

Results

• As per data, the risk of early progression on ADT was lower with PSA doubling time (DT) 3–9 months (OR=0.19) and ≥9 months (OR=0.10; both p < 0.001) prior to ADT.
• Findings suggested that metastatic disease were the independent predictors of CSS at the time of ADT initiation (HR=2.60), PSA 5–50ng/ml (HR=2.68), PSA ≥50ng/ml (HR, 4.33), DT 3–9 months (HR=0.54), and DT ≥9 months (HR=0.45; all p < 0.001).
• Researchers noted PSA 5–50ng/ml (HR=3.10) and ≥50ng/ml to be independent predictors of OS (HR=5.20; both p < 0.001).