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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author 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
author_facet 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
author_sort Maria Schubert
collection DOAJ
description 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.
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spelling doaj-art-5bc149157e0d40f9968d8ebbb11372132025-08-20T02:05:13ZengWileyAdvances in Urology1687-63691687-63772012-01-01201210.1155/2012/612707612707The Role of Adjuvant Hormonal Treatment after Surgery for Localized High-Risk Prostate Cancer: Results of a Matched Multiinstitutional AnalysisMaria Schubert0Steven Joniau1Paolo Gontero2Susanne Kneitz3Claus-Jü rgen Scholz4Burkhard Kneitz5Alberto Briganti6R. Jeffrey Karnes7Bertrand Tombal8Jochen Walz9Chao-Yu Hsu10Giansilvio Marchioro11Pia Bader12Chris Bangma13Detlef Frohneberg14Markus Graefen15Fritz Schröder16Paul van Cangh17Hein van Poppel18Martin Spahn19Department of Urology and Pediatric Urology, Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Oberdü rrbacher Strasse 6, 97080 Wü rzburg, GermanyDepartment of Urology, University Hospitals Leuven, 3000 Leuven, BelgiumDepartment of Urology, University of Turin, 10126 Turin, ItalyMicroarray Unit, University of Würzburg, 97078 Würzburg, GermanyMicroarray Unit, University of Würzburg, 97078 Würzburg, GermanyDepartment of Urology and Pediatric Urology, Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Oberdü rrbacher Strasse 6, 97080 Wü rzburg, GermanyDepartment of Urology, Vita-Salute San Raffaele University, 20132 Milan, ItalyCollege of Medicine, Mayo Clinic, Rochester, MN 55905, USADepartment of Urology, Université Catholique De Louvain, 1348 Brussels, BelgiumDepartment of Urology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Urology, University Hospitals Leuven, 3000 Leuven, BelgiumDepartment of Urology, University of Piemonte Orientale, 28100 Novara, ItalyDepartment of Urology, Community Hospital Karlsruhe, 76133 Karlsruhe, GermanyDepartment of Urology, Erasmus MC, 3015 CE Rotterdam, The NetherlandsDepartment of Urology, Community Hospital Karlsruhe, 76133 Karlsruhe, GermanyDepartment of Urology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Urology, Erasmus MC, 3015 CE Rotterdam, The NetherlandsDepartment of Urology, Université Catholique De Louvain, 1348 Brussels, BelgiumDepartment of Urology, University Hospitals Leuven, 3000 Leuven, BelgiumDepartment of Urology and Pediatric Urology, Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Oberdü rrbacher Strasse 6, 97080 Wü rzburg, GermanyIntroduction. 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.http://dx.doi.org/10.1155/2012/612707
spellingShingle 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
The Role of Adjuvant Hormonal Treatment after Surgery for Localized High-Risk Prostate Cancer: Results of a Matched Multiinstitutional Analysis
Advances in Urology
title The Role of Adjuvant Hormonal Treatment after Surgery for Localized High-Risk Prostate Cancer: Results of a Matched Multiinstitutional Analysis
title_full The Role of Adjuvant Hormonal Treatment after Surgery for Localized High-Risk Prostate Cancer: Results of a Matched Multiinstitutional Analysis
title_fullStr The Role of Adjuvant Hormonal Treatment after Surgery for Localized High-Risk Prostate Cancer: Results of a Matched Multiinstitutional Analysis
title_full_unstemmed The Role of Adjuvant Hormonal Treatment after Surgery for Localized High-Risk Prostate Cancer: Results of a Matched Multiinstitutional Analysis
title_short The Role of Adjuvant Hormonal Treatment after Surgery for Localized High-Risk Prostate Cancer: Results of a Matched Multiinstitutional Analysis
title_sort role of adjuvant hormonal treatment after surgery for localized high risk prostate cancer results of a matched multiinstitutional analysis
url http://dx.doi.org/10.1155/2012/612707
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