The Rate Of Progress Of Prostate Cancer After Endocrine Therapy Prediction

Partâ… Analysis of Factors Influencing the Progression-free Survival Time after Endocrine Therapy for Prostate CancerObjective To analyze the factors that influence the progression-free survival time after endocrine therapy for prostate cancer.Methods A total of 116 cases of prostate cancer treated with endocrine therapy were reviewed. Univariate (log-rank test) and multivariate Cox proportional hazard model was used to investigate the impact of the factors, which included age at diagnosis, pretreatment total prostate-specific antigen (PSA) level,Gleason score,clinical stage, type of endocrine therapy,DRE. The relationship of these factors was analyzed in Spearman rank correlation analyses.Results In stepwise Cox proportional hazard model, the independent prognostic factors for progression after endocrine therapy were Gleason score (P=0. 013) and clinical stage ( P<0. 001). For each unit increase in Gleason sum the cumulative hazard of progression after endocrine therapy increased from a baseline hazard ratio of 1.0 to 2.126, and to 6.625 for each unit increase in clinical stage. Pretreatment PSA level was associated with both Clinical stage (p<0.001) and Gleason score (p=0.002).Conclusions In this patient cohort, clinical stage and Gleason score were independent prognostic factors for progression after endocrine therapy. Partâ…¡Expression of potential molecular markers in prostate cancer:Correlation with progression in patients after Endocrine TherapyObjective To evaluate the expression levels of multiple potential molecular markers in prostate cancer to clarify the significance of these markers as prognostic indicators in patients under endocrine therapy.Methods A series of 116 prostate cancer patients under endocrine therapy as a single treatment was studied. Expression levels of 7 proteins, including androgen receptor(AR),E-cadherin,Chromogranin A(CgA),Ki-67,survivin,EZH2 and hepsin, in biopsy or TURP specimens obtained from these 116 patients were measured by immunohistochemical staining.Results Of the 7 molecules, Ki67,EZH2 and survivin expression were significantly associated with several conventional prognostic factors. Univariate analysis identified clinical stage,Gleason sum,pretreatment serum PSA level,Ki-67 and survivin expression as significant predictors for prostate-specific antigen (PSA) progression after endocrine therapy. Of these significant factors, survivin expression, clinical stage and Gleason sum appeared to be independently related to PSA progression after endocrine therapy by multivariate analysis. Furthermore, there were significant differences in PSA progression-free survival according to positive numbers of these three independent risk factors.Conclusions Survivin is a useful independent prognostic factor in prostate cancer undergoing endocrine therapy, for use in addition to clinical stage and Gleason score. Combined evaluation of survivin expression, clinical stage and Gleason score would be particularly useful for further refinement of the system in predicting biochemical outcome for those receiving endocrine therapy.