The possibility of hormone-mediated PSA derangement in prostate cancer treatment

Background: this study was designed to suggest the possibility of hormone-relatedderangement in salvage radiotherapy (srt) atier radical prostatectomy in terms ofprostate-specific antigen (psa) control. materials and methods: among 160consecutive prostate cancer patients who received radical prostatectomy, 34 withsrt between 2004 and 2012 were retrospectively reviewed. the numbers ofpatients with pathologic t3-t4 stage, gleason score 8-10, and positive resectionmargin were 11 (32.4%), 10 (29.4%), and 17 (50.0%), respectively. median srt dosewas 64.8 gy (range, 52.9-70.0 gy) with 1.8-2.3 gy fractionations. biochemical failure-free survival atier srt was counted and the median follow-up period was 32.5months (range, 10-118 months). results: atier srt, the median time for psa todecrease to less than 0.2 ng/ml was four months (range, 0-25 months). thethree-year survival rate was 60.3%. on univariate analysis, preferentialhormone therapy (pht) (p=0.022), higher psa at srt (p=0.005), and higherpsa atier surgery (p=0.003) were related to a shorter biochemical survivalperiod. on multivariate analysis, lower psa at srt (p=0.016), higher radiationdose (p=0.007), and non-pht (p=0.046) suggested a consistent psa control.conclusion: according to these results, low psa values by hormonal interventionneed to be reconsidered with a different way to look at the relationship betweenthe psa and hormone therapy. srt should be considered for postoperative salvagetreatment regardless of the hormone-related psa values.