Androgen deprivation therapy to prevent bladder cancer recurrence.

Abstract

329 Background: Accumulating preclinical evidence indicates the involvement of androgen receptor signals in bladder cancer (BC) development and further suggests androgen deprivation therapy (ADT) as a new therapeutic option for BC. However, the clinical efficacy of ADT in BC recurrence remains unclear. We compared the rates of BC recurrence in prostate cancer (PC) patients between who did and did not receive ADT. Methods: We retrospectively reviewed 20,328 patients with PC diagnosed during1991-2013 and identified 239 (1.2%) men having primary BC. Among them, 162 patients met the inclusion criteria. Using Kaplan-Meier analyses and Cox proportional hazard models, we assessed the prognostic significance of ADT and other clinical variables for recurrence-free survival (RFS) and cumulative recurrence. Results: With a median follow-up of 62 months, 38 (50%) of 76 control patients experienced BC recurrence, while 19 (22%) of 86 did in ADT group. Thus, patients having received ADT showed a significantly lower risk of BC recurrence (5-year actuarial RFS: 76% v 40%; P < 0.001) compared to the control group. ADT patients also had a significantly smaller number of recurrence episodes (5-year cumulative recurrence: 0.44 v 1.54; P < 0.001) compared to control patients. A multivariate analysis revealed ADT as an independent prognosticator (hazard ratio, 0.29; 95% confidence interval, 0.17-0.49) for BC recurrence. Conclusions: This is the first clinical study showing that ADT significantly reduces the risk of BC recurrence. Randomized clinical trials are required to confirm these findings. Clinical trial information: 000012926.