Endocrine therapy of prostate cancer is designed to eliminate the action of androgens to prevent the growth of hormone-sensitive cancer cells. The duration and quality of the response to this treatment vary from one patient to another. The objective of this study was to evaluate the prognostic factors of patients treated by first-line endocrine therapy for prostate cancer.
MATERIAL AND METHODS
From September 1988 to September 1999, 170 patients receiving first-line endocrine therapy for prostate cancer were included. Endocrine therapy consisted of LHRH analogues alone in 59.4% of cases, complete androgen suppression in 21.2% of cases, antiandrogens alone in 17.6% of cases and oestrogens in 1.8% of cases. Clinical, laboratory, scintigraphic and histological data were collected. The overall survival was studied by univariate analysis as a function of pretreatment criteria using Kaplan-Meier survival curves.
The mean survival of the population was 33 +/- 26 months (range: 2-126 months). The following parameters were associated with a significant reduction of overall survival: age greater than 70 years, high ECOG score, mode of presentation of the cancer by alteration of general state, presence of bone pain, presence of bone metastases particularly in the appendicular skeleton, dilatation of renal cavities, Gleason score > 5, PSA level > 100 ng/ml, haemoglobin < 13.5 g/dl, serum creatinine > 105 mumol/l, low plasma testosterone, high alkaline phosphatase, poor response to treatment assessed by PSA greater than 4 ng/ml at 3, 6 and 12 months.
Determination of these prognostic factors can be used to predict the patient's response to endocrine therapy and survival. These factors can also be used to stratify patients in comparable groups for clinical trials.