Radical prostatectomy and adjuvant endocrine therapy for prostate cancer with or without preoperative androgen deprivation: Five-year results.
Int J Urol
; 11(5): 295-303, 2004 May.
Article
en En
| MEDLINE
| ID: mdl-15147545
ABSTRACT
BACKGROUND:
The effects of preoperative androgen deprivation on the outcomes of prostate cancer patients who received radical prostatectomy and subsequent adjuvant endocrine therapy have not yet been fully evaluated.METHODS:
Patients with stage A(2), B or C prostate cancers were randomized to one of two groups group I (n = 90), who received androgen deprivation (leuprolide and chlormadinone acetate) for 3 months followed by radical prostatectomy and subsequent adjuvant endocrine therapy (leuprolide alone), and group II (n = 86), who underwent the surgery followed by 3-month androgen deprivation (leuprolide and chlormadinone acetate) and subsequent adjuvant endocrine therapy (leuprolide alone). The effects of preoperative androgen deprivation on survival, clinical relapse (serum prostate specific antigen, PSA, above the normal level, local recurrence, or distant metastases), and PSA relapse (PSA above the detectable level) were evaluated at 5 years or later after treatment.RESULTS:
There were no significant differences in overall, cause-specific, clinical relapse-free, or PSA relapse-free survival rates between the two groups. In a subanalysis, no prostate cancer deaths or clinical relapses were noted in 29 patients with organ-confined disease (OCD negativity of capsular invasion, seminal vesicle invasion, surgical margins or nodal involvement). The odds ratio for OCD depending on group assignment was 2.44 (95% confidence interval, CI 1.04-5.72), for group I, demonstrating a higher probability of having OCD. This ratio was increased to 4.00 (95% CI 1.06-15.16) if the analysis was conducted in a subpopulation with prostate specific antigen levels less than 35.6 ng/mL and with clinical stage B or C cancers.CONCLUSION:
Preoperative androgen deprivation has no demonstrable benefit in 5-year outcomes for patients undergoing radical prostatectomy and adjuvant endocrine therapy. However, it did increase the probability of OCD, which was associated with no clinical relapse during the follow-up. A longer observation is needed to clarify the exact extent of the benefits in terms of survival.
Buscar en Google
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Prostatectomía
/
Neoplasias de la Próstata
/
Acetato de Clormadinona
/
Leuprolida
/
Antineoplásicos Hormonales
/
Antagonistas de Andrógenos
Tipo de estudio:
Clinical_trials
Límite:
Aged
/
Aged80
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Int J Urol
Asunto de la revista:
UROLOGIA
Año:
2004
Tipo del documento:
Article
País de afiliación:
Japón
Pais de publicación:
AU
/
AUSTRALIA
/
AUSTRÁLIA