Survival following primary androgen deprivation therapy among men with localized prostate cancer

Abstract

5014 Background: Despite a lack of data, increasing numbers of patients have turned to primary androgen deprivation therapy (PADT) as an alternative to surgery, radiation or active surveillance for the management of localized prostate cancer. We studied the impact of PADT on survival and use of secondary therapy in elderly men with localized prostate cancer. Methods: Medicare claims linked to Surveillance, Epidemiology and End Results (SEER) data were used to assemble a cohort of 19,271 men with T1-T2 prostate cancer without local therapy within 6 months of cancer diagnosis. Instrumental variable analysis was used to overcome potential overt and hidden biases associated with unmeasured confounding variables. Results: Even though 41% of the population received PADT (median age 77), PADT use was not associated with improved median overall survival (114 vs. 113 months, hazard ratio [HR] 1.00; 95% CI 0.95–1.05) or cumulative risk of receiving secondary cancer therapy (31% at 10 years, HR 0.95; 95% CI 0.88 - 1...