Efficacy Of Primary Hormone Therapy For Localized Or Locally Advanced Prostate Cancer: Results Of A 10-year Follow-up

In the September 2006 issue of the British Journal of Urology International, Dr Akaza and associates in Japan report 10-year outcomes of men treated with androgen deprivation therapy (ADT) for localized and locally advanced prostate cancer (CaP).

The report is an extension of 5-year data that included men treated between 1993 and 1995 and compares two groups of patients. Study 1 was 176 men treated with radical prostatectomy (RP) and randomized to ADT for 12 weeks pre-operatively or only RP. All men then had ADT for 2 years after surgery. Study 2, accrued during the same time frame randomized 151 men to ADT either as LHRH monotherapy or combined androgen blockade. Combined androgen blockade include a steroidal anti-androgen. Patients were stratified by tumor risk. In study 1, men were generally younger and of higher risk stratification.

At a median follow-up of 10.4 years, 20 men in Study 1 and 17 men in Study 2 died from CaP and 21 men in Study 1 and 50 men in Study 2 died from other causes. The 10-year overall survival for Study 1 patients was 73%, and the 10-year cause-specific survival was 86%. This compared to 41% and 78% for Study 2 patients, respectively. There were no significant differences between the studies in the 10-year cause-specific survival or metastasis-free survival stratified by risk groups.

Limiting the study is the conclusion that primary ADT improves life expectancy in men with localized or locally advanced CaP, as no watchful waiting group was included as a control.

By Christopher P. Evans, M.D.

BJU International
Volume 98 Page 573-579 - September 2006
Link here.

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