Abstract
Background and Objectives: Prostate cancer progression is influenced by Gleason scores and prostate-specific antigen levels. This study aims to find the association between these markers and the duration until disease progression in patients undergoing androgen deprivation therapy.
Methods: This retrospective cohort study included 108 patients with prostate cancer treated at Nanakali Hospital and Rizgary Teaching Hospital in Erbil, Iraq. Data on demographics, clinical variables (prostate-specific antigen levels, the lowest prostate-specific antigen level reached after initiation of androgen deprivation therapy, Gleason score, and time to disease progression), and sites of metastasis were collected.
Results: Patients with metastatic disease had higher initial prostate-specific antigen levels (median 102 nanograms per deciliter) compared to non-metastatic patients (median 20.5 nanograms per deciliter, p<0.001). In metastatic cases the lowest prostate-specific antigen level reached was significantly higher (median 2.3 nanograms per deciliter) than in non-metastatic cases (median 0.1 nanograms per deciliter, p<0.001). The duration until disease progression was shorter for metastatic patients (median 9 months) than for non-metastatic patients (median 26 months, p<0.001). A negative correlation was observed between the initial prostate-specific antigen levels and time to progression in non-metastatic cases (rho = -0.859, p<0.001). The time to the lowest prostate-specific-antigen level after treatment was positively correlated with time to progression (rho = 0.857, p<0.001).
Conclusion: Initial prostate-specific antigen levels, Gleason scores, and prostate-specific antigen dynamics are valuable predictors of disease progression and should inform treatment strategies.