Duration of Androgen Suppression in Prostate Cancer

Abstract

To the Editor: In the trial conducted by Bolla et al. (June 11 issue), 1 more than 70% of the patients had clinical T3 disease, and the median level of prostate-specific antigen (PSA) in patients who underwent randomization was 18.8 ng per milliliter, with a range of up to 159.2. Furthermore, about 20% of the patients presented with Gleason scores of 5 or less, suggesting that these tumors were downgraded as compared with current trends in diagnosis. 2 Since bone scans were not mandated as part of the study, a clinically significant number of patients were likely to have had metastatic disease at presentation. The study, therefore, has limited applicability for most patients whose disease is diagnosed with the use of PSA screening. For patients with an intermediate risk of disease as defined by D’Amico et al., 3 short-term androgen suppression should not be considered inferior to long-term treatment.