Prognosis of prostate cancer with initial prostate-specific antigen >1,000 ng/mL at diagnosis

Figures & data

Table 1 Patient characteristics

	Mean	Min	Max	P-value
Age, years	73.49	52	95
PSA, ng/mL	3,323	1,003	23,126	0.123
<65 (n=12, 13%)	5,083	1,057	23,126
65–79 (n=55, 61%)	2,909	1,003	9,401
≥80 (n=23, 26%)	3,391	1,032	15,126
Gleason score		No	%	<0.001
7		6	7.7
8		14	17.9
9		48	61.5
10		10	12.8
Bone scan score		No	%	<0.001
1+2		8	11.4
3+4		62	88.6

Notes: Bone scan score 1: benign lesion; score 2: equivocal lesion; score 3: possible malignancy; score 4: high probability of malignancy.

Abbreviation: PSA, prostate specific antigen.

Table 2 Comparison of patient characteristics and outcomes with or without orchiectomy

	Orchiectomy*	N**	P-value
Number of patients	46	44
Age, median (years)	72	76	0.057
Range	53–89	52–95
iPSA, median (ng/mL)	2,400	1,604	0.042
Range	1,003–23,126	1,032–8,293
Gleason score, mean	9	8.79	0.8
PSA nadir, median	4.18	3.00	0.836
Range	0.01–3,527	0.01–1,311
≤4, n (%)	22 (47.8)	20 (45.5)
>4, n	24	24
Time to nadir, mean (mths)	11.54	9.97	0.445
SRE, n (%)	1 (2.2)	1 (2.3)	1
Follow-up, median (mths)	16.2	9.1	0.004
Range	1.3–72.7	0.3–70.5
Mortality, n (%)	2 (4.3)	12 (27.3)	0.003

Notes:

* Denotes prompt orchiectomy in <6 months following PCa diagnosis.

** Denotes medical castration or delayed orchiectomy, ≥6 months after PCa diagnosis.

Abbreviations: iPSA, initial prostate specific antigen; mths, months; SRE, skeletal-related events.

Figure 1 Survival difference in three age groups.

Figure 2 Survival difference between lower and higher quartiles of iPSA.

Abbreviation: iPSA, initial prostate specific antigen.

Figure 3 Dot plot of iPSA in patients who selected treatment options with or without orchiectomy.

Abbreviation: iPSA, initial prostate specific antigen.

Figure 4 Survival difference between patient groups that chose treatment options with or without orchiectomy.

Figure 5 Survival difference between patient groups who did or did not reach TN following primary androgen deprivation therapy. (denoting nadir PSA value that over 90% of iPSA reduction after primary androgen deprivation therapy).

Abbreviations: iPSA, initial prostate specific antigen; TN, true nadir.

Figure 6 In patients that reached true nadir PSA, orchiectomy still provided survival advantage in this study cohort.

Table 3 Cox regression analysis

	HR	95% CI	P-value
Age	4.57	1.45–14.37	0.009
True nadir	0.12	0.03–0.58	0.008
Orchiectomy	0.22	0.65–0.76	0.016

Abbreviations: CI, confidence interval; HR, hazard ratio.