The role of adjuvant hormonal treatment after surgery for localized high-risk prostate cancer: results of a matched multiinstitutional analysis
Schubert, Maria × Joniau, Steven Gontero, Paolo Kneitz, Susanne Scholz, Claus-Jürgen Kneitz, Burkhard Briganti, Alberto Karnes, R Jeffrey Tombal, Bertrand Walz, Jochen Hsu, Chao-Yu Marchioro, Giansilvio Bader, Pia Bangma, Chris Frohneberg, Detlef Graefen, Markus Schröder, Fritz van Cangh, Paul Van Poppel, Hendrik Spahn, Martin #
Hindawi Publishing Corp.
Advances in Urology vol:2012
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.