Does Primary Androgen-Deprivation Therapy Improve Survival for Localized Prostate Cancer?

Abstract

Evaluation of: Lu-Yao GL, Albertsen PC, Moore DF et al.: Survival following primary androgen deprivation therapy among men with localized prostate cancer. JAMA 300(2), 173–181 (2008). Despite a lack of data, many patients receive primary androgen-deprivation therapy (PADT) for the treatment of localized prostate cancer. To evaluate the association between PADT and survival, a population-based cohort study was conducted in 19,271 men with clinical stage T1–T2 prostate cancer. The primary outcome measures were prostate cancer-specific and overall survival. Comparing 7867 patients who received PADT with 11,404 patients who underwent conservative management, the 10-year cancer-specific survival was lower with the PADT group and overall survival was found to be similar between the groups. However, in the subset with poorly differentiated cancer, PADT was associated with improved cancer-specific, but not overall, survival. This suggests that PADT is not associated with improved survival in the majority of elderly men compared with conservative management.