Evaluation of prostate specific antigen in the prognosis of patients with advanced prostate cancer
Palavras-chave:
PSA, Advanced prostate cancer, Maximum blockage androgen, Prognostic factorsResumo
De fevereiro de 1987 a junho de 1995, 92 pacientes com câncer de próstata avançado foram submetidos a bloqueio androgénico máximo (subcapsular orquiectomia e antiandrógeno), independente dos sintomas clínicos apresentados na sua admissão. A idade dos pacientes variou de 44 a 89 anos, com mediana de 70 anos de idade. No 6o, 36o e 60o meses, a sobrevida global foi de 80%, 38% e 20%, respectivamente. O PSA pré-operatório variou de 2 a 4017 ng/ml, com mediana de 98 ng/ml e 98% dos pacientes tinham PSA maior ou igual a 10 ng/ml. O primeiro PSA pós-operatório variou de 1 a 3840 ng/ml, com mediana de 20 ng/ml. Neste estudo retrospectivo, 97% e 88,2% dos pacientes tinham PSA pré-operatório maior que 4 e 20 ng/ml, respectivamente. Houve somente uma tendência de melhor sobrevida nos pacientes com PSA inicial de 2 a 99 ng/ml (p=0,06745) que com PSA maior que 100 ng/ml. Há uma tendência de diminuição do PSA até o sexto mês depois do início do tratamento. A sobrevida dos pacientes em 36 meses após o bloqueio androgênico máximo, de acordo com o primeiro nível do PSA de 1 a 4, 5 a 49 e maior que 49 ng/ml foi de 72%, 48% e 8%, respectivamente (p=0.00004). No último exame, 34 (37%) dos pacientes foram considerados estabilizados e 58 (63%) com progressão da doença.
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