351 INTERMITTENT ANDROGEN DEPRIVATION AS SECONDARY THERAPY FOR BIOCHEMICAL RECURRENCE OF LOCALIZED PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized1 Apr 2011351 INTERMITTENT ANDROGEN DEPRIVATION AS SECONDARY THERAPY FOR BIOCHEMICAL RECURRENCE OF LOCALIZED PROSTATE CANCER Rafael Sanchez-Salas, Dominique Prapotnich, Fernando Secin, Ricardo Favaretto, Francois Rozet, Vincent Flamand, Marc Galiano, Nathalie Cathala, Annick Mombet, Eric Barret, and Xavier Cathelineau Rafael Sanchez-SalasRafael Sanchez-Salas Paris, France More articles by this author , Dominique PrapotnichDominique Prapotnich Paris, France More articles by this author , Fernando SecinFernando Secin Buenos Aires, Argentina More articles by this author , Ricardo FavarettoRicardo Favaretto Paris, France More articles by this author , Francois RozetFrancois Rozet Paris, France More articles by this author , Vincent FlamandVincent Flamand Paris, France More articles by this author , Marc GalianoMarc Galiano Paris, France More articles by this author , Nathalie CathalaNathalie Cathala Paris, France More articles by this author , Annick MombetAnnick Mombet Paris, France More articles by this author , Eric BarretEric Barret Paris, France More articles by this author , and Xavier CathelineauXavier Cathelineau Paris, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.436AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To present the long term oncological outcomes of patients treated with Intermittent Androgen Deprivation (IAD) after biochemical recurrence of localized prostate cancer. METHODS Between 1992 and 2010, 654 patients with prostate cancer (PC) were selected for IAD at our institution. Out of these, 263 patients (40%) had a biochemical recurrence (BCR) after local treatment and 146 patients with a minimum follow-up of 5 years were selected for the study. On-treatment period (ONTP) was gonadatropin-releasing hormone (GnRH) agonist and androgen receptor antagonist. Off-treatment period (OFTP) was indicated when PSA was < 4 ng/ml. Criteria for resumption of hormonal therapy were PSA > 20 ng/ml or clinical symptoms. Cancer specific survival curves were computed according to the Kaplan-Meier method. RESULTS Median follow-up was 93.4 months (61–219.3). Median age was 69.8 years (52.4–81.8.146 patients were primarily treated either by surgery(72) or by a physical therapy(74) like external radiation, brachytherapy or high intensity focused ultrasound (HIFU. Median PSA at initial IAD was 9.8 ng/ml (4.2–25). Median time from local treatment and IAD was 29.2 months (2–52). Cycle duration decreased progressively from 18.2 months for the 1st cycle to 11.3 months at the 5th cycle then stabilized until the 11th cycle. 55 patients (38%) became non responsive to IAD (PSA still >4 ng/ml after ONTP) and evolved towards continuous androgen deprivation(CAD), among these patients, 50(34%) became hormone resistant (PSA rising up more than + 2 ng/ml despite CAD) and underwent chemotherapy. Death occurred in 50 patients (34%) and 24(16%) was cancer related in a median time of 69 months(65–145) after the beginning of IAD. Mean cancer specific survival probability for the series is 122 months (78.6–105.1). Multivariate analysis of cancer specific survival demonstrates age, initial Gleason score and initial PSA level as significant factors affecting mortality. As IAD was given after a surgery procedure or a radiation procedure, the impact of IAD on the assessment of quality of life in term of sexual function or urinary continence by the mean of questionnaires was not reliable. Decrease of side-effects related to IAD was strongly underlined by patient during the OFTP when compared to the ONTP. CONCLUSIONS At a long term evaluation IAD after failure of primary treatment shows a good efficacy with a long term survival rate associated to a minimal amount of side-effects. Duration of cycle decreased progressively during therapy. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e142-e143 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rafael Sanchez-Salas Paris, France More articles by this author Dominique Prapotnich Paris, France More articles by this author Fernando Secin Buenos Aires, Argentina More articles by this author Ricardo Favaretto Paris, France More articles by this author Francois Rozet Paris, France More articles by this author Vincent Flamand Paris, France More articles by this author Marc Galiano Paris, France More articles by this author Nathalie Cathala Paris, France More articles by this author Annick Mombet Paris, France More articles by this author Eric Barret Paris, France More articles by this author Xavier Cathelineau Paris, France More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...