前列腺特異抗原的數值是否會影響5甲還原酵素抑制劑治療前列腺肥大的結果?
劉鐘琪, 林克勳, 林雍偉, 蕭志豪, 許志呈, 李良明, 陳俊佑, 溫玉清
Does PSA level affect the treatment outcomes in men with benign prostate hyperplasia using dutasteride?
Chung-Chi Liu1, Ke-Hsun Lin1, Yung-Wei Lin 1,2, Chi-Hao Hsiao 1, Chih-Chen Hsu1, Liang-Ming Lee1 , Chun-You Chen3, Yu-Ching Wen 1,2*
1 Department of Urology, Wan Fang Hospital, Taipei Medical University, Taiwan
2 Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taiwan
3 Department of Radiation oncology, Wan Fang Hospital, Taipei Medical University, Taiwan
Objective: To investigate whether the initial PSA level affects the treatment outcomes of patients using dutasteride.
Methods: We reviewed medical charts for patients using dutasteride during the period of Jan 2010 to Dec 2015. Differences in prostate volume and Qmax prior and after using dutasteride were analyzed. PSA density and initial prostate size impact on the treatment outcomes were analyzed.
Results: A total of 112 patients were included in the study. Prostate volume was significantly reduced with the use of dutasteride. Uroflowmetry results as measured by Qmax also showed improvements. Initial PSA level and PSA density have no correlation with either prostate volume reduction or peak urinary flow improvement. Larger initial prostate sizes showed significant reduction in prostate volume after using dutasteride, especially those with larger than 45 cm3. Significant disease progression during treatment was found in higher initial PSA level group (>10 ng/mL) (p<0.05).
Conclusion: Dutasteride significantly reduced the prostate volume and improve uroflowmetry results. Initial PSA level does not affect the treatment outcomes. Significant reduction in prostate volume was noted in larger initial prostate sizes, especially those larger than 45 cm3. Higher PSA level may imply disease progression, with increased risk for complications warranting closer attention to these patients.