Retrospective study of relationship between Gleason grading scrore and pre and post treatment serum PSA level

초록

INTRODUCTION PSA and Gleason grading score are wtll known [nognostic factors of prostatic cancel Especially HSA changes of pic and post treatment peril id have invaluable sigmticaniv m predicting treatment outcome. Also (Reason grading .score above 8 means poor pirgnosis In this study we retrospectively checked relationship between Gleason grading score and pie and post treatment period PSA changes MATRKIAI, AND METHOD : Total 50 patients who were diagnosed as stage U prostatic cancel between May 1992 and May 1996 in Korea Umversitv were studied retrospectivelyMean follow up duration was 189 months Anil mean age of patients was -tf vears All data was stalisiically processed bv student t lest RESULT : From 50 patients. 36 pjiHenls were treated with orchicciomv ur orchit-ctomv plus additional treatment (14 patients orchietomy only 18 patients : orrhiectomy daily antiandrogen (Flutamide) 2 patients urchu-Vtcimy-daily anuandnjfien radiation treatment ,2 patients oiLliieclumviadialion tre.-it merit) And the other 14 patients were treated bv sjonadoiroum releasin hormone ;malugLie ( Xoladex i patients . Xolsdex dailv I-lutamideJ 1.} patients) treatment. Pretreatment PSA mean value of 50 patients was ISfj.J ng/ml and basal PSA iik-an value after treatment wa-; 9fi ng/ml The mean time (o basal PSA fall after treatment wa IIi months and mean time to reelevation of PSA value was 2, 4 months Mean Cli-ason guiding score of total f0 patients was 61) and 14 patients h;id Gleason grading score above X and the other .% patiens had Gleason grading score below 7. All 14 patients whose (:lc;is(in grading score was above 8 had been treated by orchictomy(5 patinets: orchiertomy iinlv. 7 patients, mchic-ctomy - Flutamide, 1 patients orchiectomy-Flutamide 1 radiation tic-aUnent) The pit-treatment PSA mean level and po.stlreatment ba?l PSA level ol 14 ijatients with high Gleasun giading scoreiH) wa.s 159 ng/ml and 41 ng/ml respectively And the mean lane in basal PSA It-vel and reelevation of PSA was 6.1 months and 20 1 months. In :36 lower .ndiierluim ciil1, 11 patients oichiectomy + Rutamide1 ; patienls orchiectomy-Kadiation Iheiainl and lemammg 14 patients weie treated by GnHH analuguel patients Xoladex onlv. I., patients 7ul;Klex-l-lutzimKleHJ Pre and post treatment basal ISA level of Il Inwei (ileruii lading -core patients wli, were treated by orchic-ctomy were 94 H ng-ml and 14.8 rig ml icspertivdv And the duration of PSA fall tu basal level and reelevaf.on were 7.6 months and nionih- respi-ctiveh lhe pre and posttreatmenl basal PSA level of lower Gleason grading o i c patient s who were treated bv ( inliH analugue were 255.3 ng/ml and 19 njl/ml lesijfctivclv And time lo basal ami teekvated PSA level were 39 and 1LM months respectivelv In total .10 patients 1l patients were identified to die ol cancer related cause and in whom onlv jiatienls had Gleasnn grading score below 7 CONCLUSION Althoug statistical significance wa.s not exist, relative shorter interval was reiuured (01 PSA reelevation m high Gleason grading score(8) patients than in lower Gleason Healed bv nuhiectomv had longei inteival toi PSA reelevation than whom treated by UiliH .inaKiiiuc with statistical significance1- I) ();)) Also most of patients who died of cancer had lugli lik-ason grading score iU2 patients). 1Ve think lhat further large scaled piospeclivi-ludu-s are needed tor rnoie t-xact clanfication ot relationship between Gleason grading scoie and pie and pn-11 real men t ISA change.