Prostate Oncology Specialists, Marina Del Rey, CA; Prostate Cancer Research Institute, Los Angeles, CA.
Seventy-three men eligible for local therapy had primary intermittent androgen deprivation (AD). Outcomes after 12 years were reviewed retrospectively. Three men experienced metastases and died. No additional metastases occurred in the remaining 70 men. Twenty-eight men underwent delayed local therapy after a median of 5.5 years. Local therapy was more frequent in younger men and in men who were at high risk.
The purpose of this study was to describe the long-term incidence of cancer progression and mortality in men with localized prostate cancer treated with primary androgen deprivation (AD).
A retrospective chart review, from a medical oncology practice specializing in prostate cancer, was conducted of 73 men eligible for surgery or radiation treated with induction AD. Entry criteria consisted of a minimum of 9 months of induction AD, treatment initiation before 1999, clinical stage < T3, and outcome defined as the incidence of delayed local therapy, cancer progression, cancer mortality, and mortality from other causes.
Median follow-up was 12 years. Fifteen men were at low risk, 38 were at intermediate risk, and 20 were at high risk. Three men (4%) experienced metastatic disease and died of prostate cancer after 3.5, 7.7, and 11 years, respectively. Two men were in the intermediate-risk category and 1 was high risk. Nineteen men (26%) died of non-prostate cancer causes. None had metastatic disease at the time of death. Of the remaining 51 survivors, none has experienced bone metastasis. Twenty-one men (29%) required no further therapy after the first induction course of AD. Twenty-four men (33%) maintained a prostate-specific antigen (PSA) level < 5.0 ng/mL with 2 to 5 cycles of intermittent AD. Twenty-eight men (38%) underwent delayed local therapy after a median of 5.5 years. Median follow-up after local therapy was 6.2 years. Three of these men experienced subsequent rising PSA levels but none has progressed to bone metastasis. Sixteen of 20 men (80%) in the high-risk category but only 12 of 53 men (23%) in the low- and intermediate-risk categories had delayed local therapy.
Primary intermittent AD is feasible for men with localized prostate cancer. Men who are younger and men with high-risk disease undergo delayed local therapy more frequently.
Written by:
Scholz MC, Lam RY, Strum SB, Labarba DJ, Becker LK, Chang P, Farhoumand N, Jennrich RI. Are you the author?
Reference: Clin Genitourin Cancer. 2011 Oct 10. Epub ahead of print.
doi: 10.1016/j.clgc.2011.07.002
PubMed Abstract
PMID: 21993252
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