Cover Image

Medical management in locally advanced and metastatic prostate cancer: Does changes in treatment policy have any specific effect on PSA levels?

Murat Bagcioglu, Cristian Surcel, Serkan Ozcan, Cristian Mirvald, Mehmet Ali Karagoz, Mert Ali Karadag, Emre Huri, Kemal Sarica
  • Cristian Surcel
    Fundeni Clinical Institute, Center of Urologic Surgery and Renal Transplantation, Bucharest, Romania
  • Serkan Ozcan
    Urology Department Artvin State Hospital, Artvin, Turkey
  • Cristian Mirvald
    Fundeni Clinical Institute, Center of Urologic Surgery and Renal Transplantation, Bucharest, Romania
  • Mehmet Ali Karagoz
    Urology Department Ankara Research and Training Hospital, Ankara, Turkey
  • Mert Ali Karadag
    Urology Department Kafkas University Faculty of Medicine, Kars, Turkey
  • Emre Huri
    Urology Department Hacettepe University, Faculty of Medicine, Ankara, Turkey
  • Kemal Sarica
    Urology Department Kartal Research and Training Hospital, Istambul, Turkey

Abstract

Objective: Androgen deprivation therapy (ADT) is commonly used as a first-line treatment for locally advanced and metastatic prostatic cancer (Pca). There is no consensus about which alternative treatment should be used after the failure of initial ADT. We aimed to investigate the effect of changes in treatment on PSA and testosterone levels. Material and methods: A total of 120 patients with an established diagnosis of either locally advanced or metastatic Pca in two different centers. Depending on the type of medical and/or surgical management protocol planned at initial presentation, all cases were divided into three main groups as follows. Group 1 (n: 80) included the patients who underwent medical management during whole follow-up period in whom the initial management protocol was later on switched to another medical treatment with different agents, Group 2 (n: 20) included patients who were initially treated with a medical management protocol and switched to surgical castration during follow-up evaluation and lastly Group 3 (n: 20) included the patients undergoing treated surgical castration as initial treatment modality without any further medical management protocol. Results: Evaluation of our data did clearly demonstrate a statistically significant difference between the initial and final PSA as well as testosterone levels in Group 1 cases. Mean PSA and testosterone levels increased significantly in these cases despite a change in hormonal therapy by using another agent for androgen deprivation. Cases in Group 2 and 3 cases did not show any statistically significant difference with respect to the mean PSA as well as testosterone values during the same follow-up period. Conclusions: Our data clearly indicated that in case of a biochemical progression, switching into another alternative medical treatment was not effective enough in limiting the rising PSA levels in a statistically significant manner when compared with the approaches of switching to surgical castration after initial medical treatment or continuing with regular and close follow-up after initial surgical castration alone.

Keywords

Prostat cancer, PSA, Hormonal therapy, Treatment changes

Full Text:

PDF
Submitted: 2017-10-21 11:22:44
Published: 2017-12-31 00:00:00
Search for citations in Google Scholar
Related articles: Google Scholar
Abstract views:
227

Views:
PDF
82

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM


Copyright (c) 2018 Murat Bagcioglu, Cristian Surcel, Serkan Ozcan, Cristian Mirvald, Mehmet Ali Karagoz, Mert Ali Karadag, Emre Huri, Kemal Sarica

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
 
© PAGEPress 2008-2018     -     PAGEPress is a registered trademark property of PAGEPress srl, Italy.     -     VAT: IT02125780185     •     Privacy