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Prediction of Survival of Metastatic Prostate Cancer Based on Early Serial Measurements of Prostate Specific Antigen and Alkaline Phosphatase

Robinson, David ; Sandblom, Gabriel LU ; Johansson, Robert ; Garmo, Hans ; Stattin, Pär ; Mommsen, Sören and Varenhorst, Eberhard (2008) In Journal of Urology 179(1). p.117-122
Abstract
PURPOSE: We determined how serial measurements of prostate specific antigen and alkaline phosphatase can be used to predict survival early in the course of hormone treated metastatic prostate cancer. MATERIALS AND METHODS: The study was based on a prospective randomized trial of 915 patients with metastatic prostate carcinoma designed to compare parenteral estrogen (polyestradiol phosphate) vs total androgen blockade. We included 697 men who survived at least 6 months and had complete serial measurements of prostate specific antigen and alkaline phosphatase. Six models were constructed based on prostate specific antigen and alkaline phosphatase at start, and after 6 months of treatment, alkaline phosphatase flare and relative prostate... (More)
PURPOSE: We determined how serial measurements of prostate specific antigen and alkaline phosphatase can be used to predict survival early in the course of hormone treated metastatic prostate cancer. MATERIALS AND METHODS: The study was based on a prospective randomized trial of 915 patients with metastatic prostate carcinoma designed to compare parenteral estrogen (polyestradiol phosphate) vs total androgen blockade. We included 697 men who survived at least 6 months and had complete serial measurements of prostate specific antigen and alkaline phosphatase. Six models were constructed based on prostate specific antigen and alkaline phosphatase at start, and after 6 months of treatment, alkaline phosphatase flare and relative prostate specific antigen velocity. We constructed time dependent receiver operating characteristic curves with corresponding area under the curve to predict death from prostate cancer within 3 years. RESULTS: The best variables to predict outcome were alkaline phosphatase at 6 months (AUC 0.79 for polyestradiol phosphate and 0.72 for total androgen blockade), alkaline phosphatase at baseline (AUC 0.70 for polyestradiol phosphate and total androgen blockade) and prostate specific antigen at 6 months (AUC 0.70 for polyestradiol phosphate and total androgen blockade). Prostate specific antigen and alkaline phosphatase levels 6 months after start of treatment give better prediction of survival than baseline levels. CONCLUSIONS: Alkaline phosphatase at start of treatment and alkaline phosphatase and prostate specific antigen after 6 months can be used to predict survival of hormone treated metastatic prostate cancer. (Less)
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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
prostate-specific antigen, prostatic neoplasms, survival, alkaline phosphatase
in
Journal of Urology
volume
179
issue
1
pages
117 - 122
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:17997442
  • wos:000251650200032
  • scopus:36749096941
  • pmid:17997442
ISSN
1527-3792
DOI
10.1016/j.juro.2007.08.132
language
English
LU publication?
yes
id
9bc0cad7-eb7f-4e38-964d-2b4c03faa6fa (old id 1139653)
date added to LUP
2016-04-01 14:37:33
date last changed
2022-04-22 04:24:10
@article{9bc0cad7-eb7f-4e38-964d-2b4c03faa6fa,
  abstract     = {{PURPOSE: We determined how serial measurements of prostate specific antigen and alkaline phosphatase can be used to predict survival early in the course of hormone treated metastatic prostate cancer. MATERIALS AND METHODS: The study was based on a prospective randomized trial of 915 patients with metastatic prostate carcinoma designed to compare parenteral estrogen (polyestradiol phosphate) vs total androgen blockade. We included 697 men who survived at least 6 months and had complete serial measurements of prostate specific antigen and alkaline phosphatase. Six models were constructed based on prostate specific antigen and alkaline phosphatase at start, and after 6 months of treatment, alkaline phosphatase flare and relative prostate specific antigen velocity. We constructed time dependent receiver operating characteristic curves with corresponding area under the curve to predict death from prostate cancer within 3 years. RESULTS: The best variables to predict outcome were alkaline phosphatase at 6 months (AUC 0.79 for polyestradiol phosphate and 0.72 for total androgen blockade), alkaline phosphatase at baseline (AUC 0.70 for polyestradiol phosphate and total androgen blockade) and prostate specific antigen at 6 months (AUC 0.70 for polyestradiol phosphate and total androgen blockade). Prostate specific antigen and alkaline phosphatase levels 6 months after start of treatment give better prediction of survival than baseline levels. CONCLUSIONS: Alkaline phosphatase at start of treatment and alkaline phosphatase and prostate specific antigen after 6 months can be used to predict survival of hormone treated metastatic prostate cancer.}},
  author       = {{Robinson, David and Sandblom, Gabriel and Johansson, Robert and Garmo, Hans and Stattin, Pär and Mommsen, Sören and Varenhorst, Eberhard}},
  issn         = {{1527-3792}},
  keywords     = {{prostate-specific antigen; prostatic neoplasms; survival; alkaline phosphatase}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{117--122}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Journal of Urology}},
  title        = {{Prediction of Survival of Metastatic Prostate Cancer Based on Early Serial Measurements of Prostate Specific Antigen and Alkaline Phosphatase}},
  url          = {{http://dx.doi.org/10.1016/j.juro.2007.08.132}},
  doi          = {{10.1016/j.juro.2007.08.132}},
  volume       = {{179}},
  year         = {{2008}},
}