The Role of Adjuvant Hormonal Treatment after Surgery for Localized High-Risk Prostate Cancer: Results of a Matched Multiinstitutional Analysis

Introduction. To assess the role of adjuvant androgen deprivation therapy (ADT) in high-risk prostate cancer patients (PCa) after surgery. Materials and Methods. The analysis case matched 172 high-risk PCa patients with positive section margins or non-organ confined disease and negative lymph nodes...

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Main Authors: Maria Schubert, Steven Joniau, Paolo Gontero, Susanne Kneitz, Claus-Jü rgen Scholz, Burkhard Kneitz, Alberto Briganti, R. Jeffrey Karnes, Bertrand Tombal, Jochen Walz, Chao-Yu Hsu, Giansilvio Marchioro, Pia Bader, Chris Bangma, Detlef Frohneberg, Markus Graefen, Fritz Schröder, Paul van Cangh, Hein van Poppel, Martin Spahn
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Advances in Urology
Online Access:http://dx.doi.org/10.1155/2012/612707
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Summary:Introduction. To assess the role of adjuvant androgen deprivation therapy (ADT) in high-risk prostate cancer patients (PCa) after surgery. Materials and Methods. The analysis case matched 172 high-risk PCa patients with positive section margins or non-organ confined disease and negative lymph nodes to receive adjuvant ADT (group 1, n=86) or no adjuvant ADT (group 2, n=86). Results. Only 11.6% of the patients died, 2.3% PCa related. Estimated 5–10-year clinical progression-free survival was 96.9% (94.3%) for group 1 and 73.7% (67.0%) for group 2, respectively. Subgroup analysis identified men with T2/T3a tumors at low-risk and T3b margins positive disease at higher risk for progression. Conclusion. Patients with T2/T3a tumors are at low-risk for metastatic disease and cancer-related death and do not need adjuvant ADT. We identified men with T3b margin positive disease at highest risk for clinical progression. These patients benefit from immediate adjuvant ADT.
ISSN:1687-6369
1687-6377