Abstract
PurposeIntermittent androgen deprivation therapy is an effective treatment for metastatic prostate cancer. However, no study to date has evaluated the long-term outcomes of this treatment among patients with prostate cancer after radical prostatectomy. We retrospectively examined the treatment outcomes of patients with prostate-specific antigen recurrence who underwent radical prostatectomy at our department.Materials and methodsOf the 690 patients who underwent radical prostatectomy for local prostate cancer between 1988 and 2011, 129 patients who received androgen deprivation therapy for prostate-specific antigen recurrence were included in this study. Patient characteristics, luteinizing hormone-releasing hormone agonist administration, and outcomes were compared between the intermittent androgen deprivation group (n = 66) and the continuous androgen deprivation therapy group (n = 63). The non-recurrence and overall survival rates were compared between groups.ResultsThirty-six patients (27.9%) experienced recurrence after luteinizing hormone-releasing hormone agonist administration. The 5-year non-recurrence rate and 10-year overall survival rate were higher in the intermittent group (92.9%) than in the continuous group (92.9 vs 57.9%, P < 0.001; and 95.9% vs 84.3%, P = 0.047, respectively). Furthermore, 63 patients (48.8%) showed a PSA nadir of less than 0.01 ng/mL after initiation of luteinizing hormone-releasing hormone agonist; among these patients, the non-recurrence rate was significantly higher in the intermittent androgen deprivation group (P = 0.003).ConclusionsIntermittent androgen deprivation therapy for prostate specific antigen recurrence after radical prostatectomy contributed to improvement of the non-recurrence rate and overall survival, and can be considered an effective therapy for better prognosis.
Highlights
In the 1940s, Huggins et al demonstrated for the first time that androgen suppression via bilateral orchiectomy relieved the symptoms of prostate cancer (PCa) [1]
Of the 690 patients who underwent radical prostatectomy for local prostate cancer between 1988 and 2011, 129 patients who received androgen deprivation therapy for prostate-specific antigen recurrence were included in this study
The 5-year non-recurrence rate and 10-year overall survival rate were higher in the intermittent group (92.9%) than in the continuous group (92.9 vs 57.9%, P < 0.001; and 95.9% vs 84.3%, P = 0.047, respectively)
Summary
In the 1940s, Huggins et al demonstrated for the first time that androgen suppression via bilateral orchiectomy relieved the symptoms of prostate cancer (PCa) [1]. The standard treatment for metastatic PCa has been androgen deprivation therapy (ADT). There are many reports that IAD for metastatic PCa is effective at minimizing side effects and reducing medical cost [9,10,11]. There are few reports on the therapeutic effect and prognosis of IAD for PCa after radical prostatectomy. Examination of long-term results of IAD for PSA recurrence after radical prostatectomy for PCa is not common clinical practice. We examined the treatment outcomes of IAD with those of luteinizing hormone-releasing hormone agonist (LHRHa) alone, which was administered to patients with PSA recurrence after radical prostatectomy at our department, and retrospectively compared these results with the treatment outcomes of patients receiving CAD
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