Prostate specific antigen (PSA) kinetic as a prognostic factor in metastatic prostate cancer receiving androgen deprivation

Metastatic prostate cancer (mPCa) has a poor outcome with median Aim: survival of two to five years. The use of androgen deprivation therapy (ADT) is a gold standard in management of this stage. Aim of this study is to analyze the prognostic value of PSA kinetics of patient treated with hormonal therapy related to survival from several published studies Systematic review and meta-analysis was performed using literature Method: searching in the electronic databases of MEDLINE, Science Direct, and Cochrane Library. Inclusion criteria were mPCa receiving ADT, a study analyzing Progression Free Survival (PFS), Overall Survival (OS), or Cancer Specific Survival (CSS) and prognostic factor of survival related to PSA kinetics (initial PSA, PSA nadir, and time to achieve nadir (TTN)). The exclusion criteria were metastatic castration resistant of prostate cancer (mCRPC) and non-metastatic disease. Generic inverse variance method was used to combine hazard ratio (HR) within the studies. Meta-analysis was performed using Review Manager 5.2 and a p-value <0.05 was considered statistically significant. We found 873 citations throughout database searching with 17 Results: studies were consistent with inclusion criteria. However, just 10 studies were analyzed in the quantitative analysis. Most of the studies had a good methodological quality based on Ottawa Scale. No significant association between initial PSA and PFS. In addition, there was no association between initial PSA and CSS/ OS. We found association of reduced PFS (HR 2.22; 95% CI 1.82 to 2.70) and OS/ CSS (HR 3.31; 95% CI 2.01-5.43) of patient with high PSA nadir. Shorter TTN was correlated with poor result of survival either PFS (HR 2.41; 95% CI 1.19 – 4.86) or CSS/ OS (HR 1.80; 95%CI 1.42 – 2.30) Initial PSA before starting ADT do not associated with survival in Conclusion: mPCa. There is association of PSA nadir and TTN with survival Referee Status: AWAITING PEER REVIEW 28 Feb 2018, :246 (doi: ) First published: 7 10.12688/f1000research.14026.1 28 Feb 2018, :246 (doi: ) Latest published: 7 10.12688/f1000research.14026.1 v1 Page 1 of 11 F1000Research 2018, 7:246 Last updated: 28 FEB 2018