A simple prognostic model involving prostate-specific antigen, alkaline phosphatase and albumin for predicting the time required to progress to castration-resistant prostate cancer in patients who received androgen deprivation therapy

Int Urol Nephrol. 2017 Jan;49(1):61-67. doi: 10.1007/s11255-016-1456-z. Epub 2016 Nov 11.

Abstract

Purpose: To distinguish potential biomarkers and build a useful model to predict the time required to progress to castration-resistant prostate cancer (CRPC) in patients with prostate cancer who have been treated with androgen deprivation therapy (ADT).

Methods: We considered 168 patients who received ADT as the initial therapy. Complete clinical data including age, tumor stage, Gleason score, prostate-specific antigen (PSA), complete blood count and liver function tests were analyzed. Cox proportional hazards regression models were used to estimate their effects on the time required to progress to CRPC, and a simple risk stratification model to predict the time required to progress to CRPC was established.

Results: One hundred and sixty-eight patients were evaluated. The median age was 72 years, and the mean time required to progress to CRPC was 15 months. Multivariable analysis indicated that PSA, alkaline phosphatase and albumin were independent predictors of ADT failure. A predictor model using these factors indicated significant differences in the time required to progress to CRPC between the three subgroups: low (score: 0), intermediate (score: 1-2) and high (score: 3-4).

Conclusion: The predictor model included PSA, alkaline phosphatase and albumin as independent prognostic factors of the time required to progress to CRPC in patients who had received ADT.

Keywords: Albumin; Alkaline phosphatase; Androgen deprivation therapy; Castration-resistant prostate cancer; Prostate-specific antigen.

MeSH terms

  • Aged
  • Alkaline Phosphatase / blood*
  • Androgen Antagonists / therapeutic use
  • Anilides / therapeutic use
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Disease Progression*
  • Gonadotropin-Releasing Hormone / agonists
  • Humans
  • Male
  • Nitriles / therapeutic use
  • Orchiectomy
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Prostate-Specific Antigen / blood*
  • Prostatic Neoplasms / blood*
  • Prostatic Neoplasms / therapy*
  • Prostatic Neoplasms, Castration-Resistant* / blood
  • Retrospective Studies
  • Serum Albumin / metabolism*
  • Time Factors
  • Tosyl Compounds / therapeutic use

Substances

  • Androgen Antagonists
  • Anilides
  • Antineoplastic Agents, Hormonal
  • Nitriles
  • Serum Albumin
  • Tosyl Compounds
  • Gonadotropin-Releasing Hormone
  • bicalutamide
  • Alkaline Phosphatase
  • Prostate-Specific Antigen